Kopitsky R G, Geltman E M
Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri 63110.
Am J Med. 1987 Sep;83(3):589-92. doi: 10.1016/0002-9343(87)90778-9.
The development of "pathologic" Q waves with ST segment elevation is considered diagnostic of transmural myocardial infarction. Previous reports have suggested that myocardial ischemia without infarction can result in electrocardiographic abnormalities simulating those of acute infarction. However, lack of infarction has been poorly documented in these reports. If real, this phenomenon could have an impact on the management of patients with apparent acute infarction. This study describes a patient with documented severe myocardial ischemia and electrocardiographic evidence of acute transmural myocardial infarction, in whom significant myocardial necrosis has been excluded definitively.
伴有ST段抬高的“病理性”Q波的出现被认为是透壁性心肌梗死的诊断依据。既往报告提示，无梗死的心肌缺血可导致类似急性梗死的心电图异常。然而，这些报告中关于无梗死的记录并不充分。如果这种现象确实存在，可能会对疑似急性梗死患者的治疗产生影响。本研究描述了一名有记录的严重心肌缺血且有急性透壁性心肌梗死心电图证据的患者，该患者已明确排除显著心肌坏死。
