动态心电图监测变异型心绞痛1例

A Case Report:Dynamic Electrocardiogram Monitoring Variant Angina Pectoris

患者男,48岁,因心前区疼痛伴紧缩感3d每于凌晨发作,持续3～4min后自行缓解,常规心电图检查无异常,既往高血压病史8年,于2011年5月10日就诊。24h 12导联同步动态心电图记录到ST段呈损伤样改变伴Ⅱ度Ⅱ型房室传导阻滞。临床诊断:冠心病、变异型心绞痛,Ⅱ度Ⅱ型房室传导阻滞、高血压病。变异型心绞痛发作时间短,常规心电图难以诊断,24h 12导联同步动态心电图可获得10万个心动周期心电信息,清楚地显示出变异型心绞痛发作的时间分布、持续时间、心肌缺血的部位与程度,为临床诊断提供可靠依据。

A 48-year-old man, presented with onset of chest pain and tightness in the early dawn of last 3 days and alleviated after 3-4 mins spontaneously, conventional electrocardiogram failed to offer any clue. He gave a history of 8 years of hypertension and was admitted on May.10th , 2011. A 24 hour 12 lead synchronized dynamic electrocardiogram recorded injury-like S-T segment change and type 2 second-degree atrioventricular block. The patient was diagnosed with coronary heart disease, variant angina pectoris, type 2 second-degree atrioventricular block and hypertension. Variant angina pectoris is hard to be diagnosed by conventional electrocardiogram for its short episode of onset. The 24 hour 12 lead synchronized dynamic electrocardiogram can acquire the information of about 100 thousand cardiac cycles, clearly show the time distribution, duration time, location and degree of myocardial infarction, and offer reliable evidence for diagnose.