Minutiello L
Regione Marche-Azienda Sanitaria n. 2 Ospedale di Urbino, Reparto di Cardiologia.
Minerva Cardioangiol. 1996 Jan-Feb;44(1-2):59-65.
The paper reports the case of a female 54-years old admitted to UTIC following recent episodes of precordial pain associated with major ECG alterations (negative T wave in precordial derivations) which appeared to indicate ischemic damage. The normality of laboratory tests and the mechanical function of the left ventricle studied using echo-Doppler raised doubts regarding the diagnosis of ischemic cardiopathy. After an interval of 2 months (during which the patient was constantly asymptomatic), owing to the persistence of ECG alterations during the recovery stage, an effort test was performed using thallium; the latter was normal and thus enabled the ischemic genesis of these alterations to be excluded. The suspension of antidepressive therapy with tricyclic agents, which the patient had taken for years, was followed after a few months by the stabilisation of ECG. This confirms that tricyclic antidepressive agents may significantly interfere with the electric activity of the myocardial cells, provoking considerable difficulties for a correct diagnosis.
该论文报告了一名54岁女性的病例，她因近期出现的心前区疼痛发作并伴有主要心电图改变（心前区导联T波倒置）而入住UTIC，这些改变似乎提示存在缺血性损伤。实验室检查结果正常，且使用超声多普勒研究的左心室机械功能对缺血性心脏病的诊断提出了疑问。在间隔2个月（在此期间患者一直无症状）后，由于恢复阶段心电图改变持续存在，遂使用铊进行了负荷试验；结果正常，从而排除了这些改变的缺血性成因。患者多年来一直服用的三环类抗抑郁药停用数月后，心电图趋于稳定。这证实三环类抗抑郁药可能会显著干扰心肌细胞的电活动，给正确诊断带来相当大的困难。
