急性下壁伴 III 导联孤立性 ST 段抬高型心肌梗死：1 例报告。
Acute inferior occlusion myocardial infarction with a solitary ST-elevation in lead III: A case report.
机构信息
Department of Cardiovasology, Changhai Hospital, Naval Military Medical University, 168 Changhai Road, Shanghai 200433, China.
Department of Cardiovasology, Changhai Hospital, Naval Military Medical University, 168 Changhai Road, Shanghai 200433, China.
出版信息
J Electrocardiol. 2022 May-Jun;72:35-38. doi: 10.1016/j.jelectrocard.2022.02.010. Epub 2022 Feb 28.
The ST-segment elevation myocardial infarction (STEMI) paradigm requires ST-segment elevation (STE) in contiguous leads on electrocardiography (ECG). STEMI criteria overlook numerous patients with acute coronary occlusion (ACO). The Aslanger pattern describes an ECG without contiguous STE, indicating acute inferior occlusion myocardial infarction (OMI) with concomitant multi-vessel disease. We describe one case of inferior OMI with one STE in lead III on initial ECG; however acute inferior STEMI was later identified. Coronary angiography showed thrombosis in the proximal right coronary artery and severe stenosis in non-infarct-related arteries. Awareness of the limitations of current STEMI criteria is crucial for timely intervention.
ST 段抬高型心肌梗死（STEMI）的诊断标准要求心电图（ECG）上相邻导联出现 ST 段抬高（STE）。然而，STEMI 标准会忽略许多急性冠状动脉闭塞（ACO）患者。Aslanger 图形描述了一种心电图上没有相邻 STE 的情况，提示急性下壁闭塞性心肌梗死（OMI）伴多支血管病变。我们描述了一例初始 ECG 中 III 导联仅有 1 个 STE 的下壁 OMI，但后来被诊断为急性下壁 STEMI。冠状动脉造影显示近端右冠状动脉血栓形成和非梗死相关动脉严重狭窄。认识到当前 STEMI 标准的局限性对于及时干预至关重要。
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