Perrenoud J J, Adamec R, Righetti A
Arch Mal Coeur Vaiss. 1980 Nov;73(11):1279-86.
The diagnosis of inferior myocardial infarction was wrongly made in a patient with a history of chest pain and Q waves in Leads 3 and aVF. Despite a normal PR interval, ventricular preexcitation was suspected on the deformation of the upstroke of the QRS complex, suggestive of a delta wave. Ventricular and coronary angiography and exercise Thallium 201 myocardial scintigraphy allowed the diagnosis of myocardial infarction to be eliminated. Endocavitary electrophysiological recordings confirmed the presence of an accessory atrioventricular conduction pathway (Kent bundle) and explained the intermittent appearances of the WPW syndrome on ECG. The patient was investigated after the acute episode, and the absence of cardiac enzyme estimations at that time made the rectification of the diagnosis more difficult.
一名有胸痛病史且心电图导联3和aVF出现Q波的患者被误诊为下壁心肌梗死。尽管PR间期正常，但根据QRS波群上升支变形怀疑存在心室预激，提示有δ波。心室造影、冠状动脉造影及运动铊201心肌闪烁显像排除了心肌梗死的诊断。心腔内电生理记录证实存在房室旁道（肯特束），并解释了心电图上预激综合征的间歇性表现。该患者在急性发作后接受了检查，当时未进行心肌酶测定，使得诊断的纠正更加困难。
