Tóth C, Csomós M, Misz M
Markhot Ferenc Megyei Kórház, Eger, I. Belgyógyászati Osztály.
Orv Hetil. 1995 Jul 9;136(28):1487-90.
In the 3 and a half year patient material of their Intensive Care Unit the authors studied the diagnostic value of the echocardiography in left bundle branch block. From the 925 patients treated this period they analysed retrospectively the clinical data of 51 patients with left bundle branch block. In 37 cases acute myocardial infarction was suspected (group A), 14 patients were hospitalized because of severe left ventricular dysfunction without chest pain (group B). The echocardiography was performed always within 48 hours after admission. In 18/37 respectively 8/14 cases the left bundle branch block had already been known from the previous examinations. In the group A the enzyme test verified acute myocardial infarction in 23 patients, in each of them segmental wall motion abnormality--either akinesis or dyskinesis--was detected by echocardiography. In group B 5 dilated cardiac diseases, 1 aortic and 2 mitral vitiums were verified by echocardiography. From the 6 patients of the group B the wall motion abnormalities were caused by acute myocardial infarction in 1 patient and by a previous myocardial infarction in 5 patients. At the Intensive Care Unit 8, and during the further observation in hospital 5 patients died. In each cases the section reinforced the findings of the echocardiography. According to the authors' experiences, echocardiography is proved to be a very useful help in the acute cardiac care of patients with left bundle branch block.
在他们重症监护病房三年半的患者资料中,作者研究了超声心动图在左束支传导阻滞中的诊断价值。在这一时期接受治疗的925例患者中,他们回顾性分析了51例左束支传导阻滞患者的临床资料。37例怀疑有急性心肌梗死(A组),14例因严重左心室功能不全且无胸痛而住院(B组)。超声心动图检查均在入院后48小时内进行。在A组的37例中,有18例,B组的14例中有8例,其左束支传导阻滞在之前的检查中就已发现。在A组中,酶试验证实23例患者有急性心肌梗死,超声心动图均检测到他们存在节段性室壁运动异常——要么运动减弱,要么运动失调。在B组中,超声心动图证实有5例扩张型心肌病、1例主动脉瓣病变和2例二尖瓣病变。在B组的6例患者中,1例患者的室壁运动异常是由急性心肌梗死引起,5例是由既往心肌梗死引起。在重症监护病房有8例患者死亡,住院进一步观察期间有5例患者死亡。在每例尸检中均证实了超声心动图的检查结果。根据作者的经验,超声心动图在左束支传导阻滞患者的急性心脏护理中被证明是非常有用的辅助手段。