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重症监护心脏病学中的心电图：切勿漏诊心肌梗死。

ECGs in Critical Care Cardiology: Do Not Miss That Myocardial Infarction.

作者信息

Chyu Kuang-Yuh, Shah Prediman K

机构信息

Smidt Heart Institute and Department of Cardiology, Cedars Sinai Medical Center, Los Angeles, California, USA.

出版信息

JACC Case Rep. 2022 Oct 5;4(19):1297-1305. doi: 10.1016/j.jaccas.2022.07.036.

DOI:10.1016/j.jaccas.2022.07.036
PMID:36406911
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9666745/
Abstract

This paper provides clinical cases of acute myocardial infarction that do not show ST-segment elevation on 12-lead electrocardiogram, but should be clinically treated as ST-segment elevation myocardial infarction with early diagnostic coronary angiogram followed by appropriate strategy of revascularization. ().

摘要

本文提供了一些急性心肌梗死的临床病例，这些病例在12导联心电图上未显示ST段抬高，但临床上应将其视为ST段抬高型心肌梗死，早期进行诊断性冠状动脉造影，随后采取适当的血运重建策略。（）

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f10/9666745/8c461775ca31/gr3a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f10/9666745/e855f34dfe24/fx1a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f10/9666745/01c367a728bd/gr2a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f10/9666745/8c461775ca31/gr3a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f10/9666745/e855f34dfe24/fx1a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f10/9666745/01c367a728bd/gr2a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f10/9666745/8c461775ca31/gr3a.jpg

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本文引用的文献

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New Electrocardiographic Algorithm for the Diagnosis of Acute Myocardial Infarction in Patients With Left Bundle Branch Block.用于诊断左束支传导阻滞患者急性心肌梗死的新心电图算法。
J Am Heart Assoc. 2020 Jul 21;9(14):e015573. doi: 10.1161/JAHA.119.015573. Epub 2020 Jul 4.
2
The de Winter ECG pattern: Distribution and morphology of ST depression.德温特心电图模式：ST 段压低的分布和形态。
Ann Noninvasive Electrocardiol. 2020 Sep;25(5):e12783. doi: 10.1111/anec.12783. Epub 2020 Jun 25.
3
Prevalence of junctional ST-depression with tall symmetrical T-waves in a pre-hospital field triage system for STEMI patients.
在ST段抬高型心肌梗死（STEMI）患者的院前现场分诊系统中，伴高耸对称T波的交界性ST段压低的患病率。
J Electrocardiol. 2019 Jan-Feb;52:1-5. doi: 10.1016/j.jelectrocard.2018.10.092. Epub 2018 Oct 18.
4
Electrocardiographic changes in patients with acute myocardial infarction caused by left main trunk occlusion.左主干闭塞导致急性心肌梗死患者的心电图改变。
J Cardiovasc Med (Hagerstown). 2018 Aug;19(8):439-445. doi: 10.2459/JCM.0000000000000684.
5
Reperfusion times and in-hospital outcomes among patients with an isolated posterior myocardial infarction: insights from the National Cardiovascular Data Registry (NCDR).孤立性后心肌梗死患者的再灌注时间和院内结局：来自全国心血管数据登记处（NCDR）的见解。
Am Heart J. 2014 Mar;167(3):350-4. doi: 10.1016/j.ahj.2013.11.011. Epub 2013 Dec 10.
6
The left bundle-branch block puzzle in the 2013 ST-elevation myocardial infarction guideline: from falsely declaring emergency to denying reperfusion in a high-risk population. Are the Sgarbossa Criteria ready for prime time?2013 年 ST 段抬高型心肌梗死指南中的左束支阻滞难题：从错误宣告紧急情况到拒绝高危人群再灌注。Sgarbossa 标准是否已经成熟可用？
Am Heart J. 2013 Sep;166(3):409-13. doi: 10.1016/j.ahj.2013.03.032. Epub 2013 Aug 6.
7
Diagnosis of ST-elevation myocardial infarction in the presence of left bundle branch block with the ST-elevation to S-wave ratio in a modified Sgarbossa rule.应用改良 Sgarbossa 规则中 ST 段抬高与 S 波比值诊断左束支传导阻滞伴 ST 段抬高型心肌梗死。
Ann Emerg Med. 2012 Dec;60(6):766-76. doi: 10.1016/j.annemergmed.2012.07.119. Epub 2012 Aug 31.
8
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J Electrocardiol. 2012 Sep;45(5):487-90. doi: 10.1016/j.jelectrocard.2012.05.001. Epub 2012 Jun 4.
9
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J Am Coll Cardiol. 2001 Nov 1;38(5):1348-54. doi: 10.1016/s0735-1097(01)01563-7.