Urumov G, Gocheva N
Vutr Boles. 1981;20(4):67-73.
The electrocardiograms of 110 patients with recent myocardial infarction treated and died at CCVD--RI of CVD, MA, were studied. The electrocardiographic image was juxtaposed to the pathological finding. The analysis revealed that 86.3 per cent of the infarctions were diagnosed and localized properly via the 12 routine leads. In the group of undistinguished transmural infarctions (11 patients) the patients with posterior myocardial infarction predominated (8 patients), patients with bundle branch block (1 patient with left bundle branch block, 2 patients with right bundle branch block and 1 patient with left anterior fascicular block) and an opposite healed myocardial infarction was present in six of the patients deceased. Among the deceased with the non-diagnosed non-transmural infarctions (4 patients), three were with a posterior localization, one with left bundle branch block and in all of them--healed myocardial infarctions were found. No complete coincidence between the ECG and pathologoanatomical idea was established as regards non-transmural and transmural myocardial infarction, because in half of the patients with non-transmural infarction, confirmed at necropsy, a pathological O deflection was found. The clinical value of the electrocardiographic classification of myocardial infarctions as transmural and non-transmural is discussed.
对110例近期发生心肌梗死并在心血管病研究所以及心血管病、医学科学院治疗和死亡的患者的心电图进行了研究。将心电图图像与病理检查结果并列对照。分析显示，86.3%的梗死通过12个常规导联能够得到正确诊断和定位。在未明确的透壁性梗死组（11例患者）中，以后壁心肌梗死患者居多（8例），有束支传导阻滞的患者（1例左束支传导阻滞、2例右束支传导阻滞和1例左前分支传导阻滞），并且在6例死亡患者中存在陈旧性心肌梗死。在未诊断出的非透壁性梗死患者（4例）中，3例为后壁梗死，1例有左束支传导阻滞，并且在所有这些患者中均发现有陈旧性心肌梗死。关于非透壁性和透壁性心肌梗死，心电图与病理解剖结果之间并未完全吻合，因为在尸检证实为非透壁性梗死的患者中，有一半发现有病理Q波。文中讨论了将心肌梗死分为透壁性和非透壁性的心电图分类的临床价值。
