摘要
目的分析磁共振定位的左室侧壁或侧壁联合下壁(侧下壁)梗死患者的心电图改变及梗死相关冠脉(infarction related artery,IRA)。方法选择2009年3月～9月在我院经磁共振心肌延迟增强(magnetic resonace imaging-myocardial delay enhancement MRI-MDE)扫描确定为左室侧壁或侧下壁梗死患者共5例,分析患者的心电图及冠脉造影结果。结果5例患者中4例Q波梗死,1例非Q波梗死,Q波梗死中2例侧下壁梗死,2例侧壁梗死,心电图均表现为V1导联高R波,R/S≥1,R波时限≥40ms,V7～V9导联病理性Q波;5例患者中4例IRA为回旋支(LCX)近段,其中2例累及钝缘支(OM),1例在LCX发出OM后次全闭塞。结论心电图V1导联高R波,R/S≥1,R波时限≥40ms,V7～V9导联病理性Q波对应于左室侧壁或侧下壁梗死,IRA多数为LCX。
Objective To analyze the ECG manifestation and coronary angiography of the lateral or inferolateral infarction verified by magnetic resonance imaging-myocardial delay enhancement （MRI-MDE）. Methods We present five cases with inferolateral or lateral infarction based on MRI-MDE to observe the ECG changes and the infarction related artery （IRA）. Results Four of them were diagnosed as Q wave infarction, and one was diagnosed as non-Q wave infarction. There were two inferolateral infarction patients and two lateral infarction patients with Q wave in lead V7-V9, and R/S amplitude ratio of 1 or greater and R wave duration of 40ms or longer in lead V1. The infarction related artery was proximal of the left circumflex artery （LCX） in four of them, and oblique marginal artery （OM） in two of them, and distal of LCX in one of them. Conclusion R/S amplitude ratio of 1 or greater and R wave duration of 40ms or longer in lead V1 and Q wave in lead V7-V9 are ECG manifestation of inferolateral infarction or lateral infarction, most of the IRA was LCX.
出处
《临床心电学杂志》
2009年第6期424-428,共5页
Journal of Clinical Electrocardiology
