Vranckx P, Ector H, Heidbüchel H
Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Belgium.
Eur J Emerg Med. 1998 Jun;5(2):253-8.
Pulmonary embolism is frequently overlooked but may be fatal. Hence, appropriate diagnosis heavily relies on clinical suspicion. Although most ECG features of pulmonary embolism lack specificity and sensitivity, especially when prior cardiopulmonary disease is present, certain ECG findings may heighten the initial clinical suspicion. This is illustrated in the following report on a case of proven pulmonary embolism complicated with cardiac arrest and prolonged shock. The electrocardiographic presentation was suggestive of an extensive acute myocardial infarction, a pattern which to our knowledge never has been reported on. However, many elements of it pointed to the diagnosis of pulmonary embolism. The multifactorial origin of the ECG findings is discussed.
肺栓塞常常被忽视，但可能致命。因此，准确的诊断在很大程度上依赖于临床怀疑。尽管肺栓塞的大多数心电图特征缺乏特异性和敏感性，尤其是在存在心肺疾病史的情况下，但某些心电图表现可能会提高最初的临床怀疑度。以下关于一例确诊为肺栓塞并发心脏骤停和长时间休克病例的报告就说明了这一点。心电图表现提示广泛急性心肌梗死，据我们所知，这种情况从未有过报道。然而，其中许多因素指向肺栓塞的诊断。本文讨论了心电图表现的多因素起源。
