心尖肥厚型心肌病的心电图特点(附31例报告)

Electrocardiogram characteristics of 31 cases of apical hypertrophic cardiomyopathy

目的探讨心尖肥厚型心肌病(AHCM)与心电图(ECG)异常的关系,提高对AHCM的诊断识别,减少误、漏诊。方法对31例AHCM患者的ECG资料进行分析。结果全部患者均合并有ECG异常改变(100%);胸前导联(V3～V6)T波倒置(0.1～2.8mV),且以V3、V4、V5导联T波倒置最为明显;上述导联ST段压低(0.05～0.4mV);V3～V5导联R波振幅明显增高;所有左心尖肥厚型病例均无异常Q波,1例全心尖肥厚型可见病理性Q波。合并心房纤颤2例(6.5%)。结论标准12导联ECG显示胸导联V3～V5R波振幅增高伴对称深倒置T波,要高度考虑AHCM的可能,ECG异常与心尖肥厚型心肌病具有相关性,是AH-CM的首要诊断依据。

Objective To investigate electrocardiographic characteristics of apical hypertrophic cardiomyopathy （AHCM） and to reduce the missed diagnosis and misdiagnosis of the disease. Methods The electrocardiographic characteristics of 31 AHCM were retrospectively reviewed. Results All the eases had abnormal electrocardiographic eharaeteristics（ 100% ）, ECG showed T wave inversion （0.1 - 2.8 mV） in V3 - V5, especially in V3 and V4 lead and ST segment depression in above leads （ 0.05 - 0.4 mV）. R wave amplitude in V3-V5 lead increased obviously; and abnormal Q wave was not observed in left apical hypertrophic cardiomyopathy cases. Only one apical hypertrophic cardiomyopathy involving right and left ventricle was observed having abnormal Q wave. Two cases were complicated with atrial fibrillation （ 6.5% ）. Conclusions When electrocardiogram shows T wave inversion in V3-V5 and R wave amplitude in V3 - V5 lead increase obviously,it highly denotes AHCM. Abnormal ECG is related to AHCM and can serve as a capital signs for clinical diagnosis of AHCM.