Cardiology, Government TD Medical College, Allapuzha, Kerala, India
Cardiology, Government TD Medical College, Allapuzha, Kerala, India.
BMJ Case Rep. 2022 Jul 20;15(7):e250667. doi: 10.1136/bcr-2022-250667.
A male in his mid 50s, chronic smoker and hypertensive for 10 years presented with history suggestive of typical angina, electrocardiographic evidence of pre-excitation and serial elevation of cardiac biomarkers. Serial electrocardiograms showed subtle changes (axis shift, horizontal ST-segment changes) that could be presumptive of an anterior wall myocardial infarction. Speckle tracking echocardiography revealed territorial reduction of longitudinal strain corresponding to the left anterior descending artery with coronary angiography corroborating the same and underwent successful revascularisation. Exercise stress testing showed abrupt and complete disappearance of delta wave and normalisation of PR interval which indicates that the patient has low risk of developing malignant arrhythmias and sudden cardiac death.
一位 50 多岁的男性，慢性吸烟者，高血压病史 10 年，有典型心绞痛病史，心电图有预激证据和心脏生物标志物的连续升高。连续心电图显示出细微的变化（轴偏移，水平 ST 段变化），可能提示前壁心肌梗死。斑点追踪超声心动图显示与左前降支相应的纵向应变的区域性减少，冠状动脉造影证实了这一点，并进行了成功的血运重建。运动应激测试显示德尔塔波的突然和完全消失以及 PR 间隔的正常化，这表明患者发生恶性心律失常和心源性猝死的风险较低。
