慢性右束支传导阻滞合并后壁闭塞性心肌梗死
Posterior Occlusive Myocardial Infarction on Chronic Right Bundle Branch Block.
作者信息
Sanchez Andrew, El-Charif Omar
机构信息
Department of Medicine Harvard Medical School, Beth Israel Deaconess Medical Center.
Section of Cardiovascular Medicine, Department of Internal Medicine Yale New Haven Hospital.
出版信息
J Brown Hosp Med. 2025 Apr 1;4(2):11-14. doi: 10.56305/001c.133705. eCollection 2025.
After experiencing syncope, a woman in her 80s with several cardiovascular risk factors presented to the emergency department with shock. The initial troponin was 3,872 ng/L, and the presenting electrocardiogram (ECG) showed a known right bundle branch block (RBBB), but with ST-segment depressions in V1-V2 out of proportion to the patient's baseline RBBB-related secondary repolarization abnormality. After 3 days of hypotension refractory to antibiotics, left heart catheterization was pursued and demonstrated 100% occlusion of the second obtuse marginal artery, confirming the patient had experienced posterior occlusive myocardial infarction (OMI). This case highlights one ECG pattern consistent with posterior OMI in patients with chronic RBBB.
一名患有多种心血管危险因素的80多岁女性在经历晕厥后因休克被送往急诊科。初始肌钙蛋白为3872 ng/L，当时的心电图（ECG）显示已知的右束支传导阻滞（RBBB），但V1-V2导联的ST段压低与患者基线RBBB相关的继发性复极异常不成比例。在使用抗生素治疗3天低血压仍无改善后，进行了左心导管检查，结果显示第二钝缘支动脉100%闭塞，证实该患者发生了后壁闭塞性心肌梗死（OMI）。本病例突出了慢性RBBB患者中一种与后壁OMI一致的心电图模式。
Zotero 插件