右胸头胸导联心电图病理性Q波意义探讨

Significance of Pathological Q Wave Display in Head Chest Lead Right Precordial HV3R-HV_R Electrocardiogram

描记135例(正常人22例、心绞痛14例、非Q波梗塞10例、前壁梗塞25例、下壁梗塞28例、下壁右室梗塞36例)右胸头胸导联心电图HV_(3R)—HV_(7R),发现前3组共46例右胸心电图全部正常。前壁梗塞组右胸心电图正常22例(88%).3例有左前降支冠脉闭塞、左室扩大合并心尖室壁瘤患者.HV_(3R)、HV_(4R)出现Q波,HV_(5R)—HV_(7R)正常。下壁梗塞组心电图正常5例(18%).Q波主要分布在HV_(5R)—HV_(7R)。下壁合并右室梗塞组全部病例HV_(6R)、HV_(7R)均含Q波。以上病理性Q波出现的范围与既往尸检所见与左室不同部位梗塞共存的右室梗塞的部位大致相符、有希望指示右室梗塞的存在。

One hundred and 35 cases (22 normal subjects, 14 cases of angina pectoris, 10 cases of non-Q-wave myocardial infarction (MI), 25 cases of anterior MI, 28 cases of inferior MI and 36 cases of left inferior MI with right ventricle MI were studied through head chest (HC) lead HV3R- HV7R ECG. The preceding three groups (a total of 46 cases) had normal right precordial ECG. In the anterior MI group normal QRS complex in HV3R-HV7R was found in 22 cases (88%), and 3 patients (12%) with obstruction of the left anterior discending artery, left ventricle enlargement complicated with anterioapical aneurysm had Q wave in HV3R and HV4R, but normal ECG in HV5R-HV7R. In the inferior MI group 5 cases (18%) had normal right chest ECG and Q wave was detected mainly in HV5R-HV7R in other 23 cases. Thirty-six cases of left inferior MI with right ventricle MI had Q wave in HV6R and HV7R. The range of these pathological Q waves was similar to the sides of right ventricle MI coexistent with MI in different locations of the left ventricle, found in previous autopsie. It is hopeful to indicate infarctions in the right ventricle by HC lead ECG.