第一对角支病变致急性心肌梗死的心电图特点

Electrocardiographic characteristics of acute myocardial infarction caused by the occlusion of the first diagonal branch

目的分析第一对角支病变导致急性心肌梗死患者的心电图特点,寻找相关规律。方法回顾性分析本院急性心肌梗死患者数据库,筛选经冠脉造影证实梗死相关血管为第一对角支的心电图资料,分析其心电图特点。结果 6例患者冠状动脉造影结果显示4例为对角支急性闭塞,2例为次全闭塞伴血栓形成。ST段抬高的导联多见于a VL、I、V2导联,所有6例患者均表现为aVL导联ST段抬高,抬高幅度(0.11±0.05)mV,其余ST段抬高患者中I导联有3例,V2导联3例。ST段压低的导联多见于Ⅲ、Ⅱ、aVF导联,所有6例患者均表现为Ⅲ导联ST段压低,压低幅度为(0.09±0.04)mV,其余ST段压低患者中Ⅱ、aVF导联各有4例。结论第一对角支病变导致急性心肌梗死的心电图特点为a VL导联伴或不伴I、V2导联ST段抬高,Ⅲ导联伴或不伴Ⅱ、aVF导联ST段压低。

Objective The aim of our study was to analyze electrocadiographic changes in patients with acute myocardial infarction related to the occlusion of the first diagonal branch, find the rule for physician to make quick diagnosis. Methods A total of 6 AMI patients with coronary angiography(CAG) confirmed diagonal branch occlusion were retrospectively analyzed and the characteristics of ECG were analyzed. Results CAG showed that 4 patients had acute occlusion of the diagonal branch and 2 patients had subtotal occlusion with thrombosis. The ST-segment elevation was most observed in leads a VL、I and V2. All 6(100%) patients were with ST-segment elevation in lead a VL(mean 0.11±0.05 mV), 3 in lead I, and 3 in lead V2. The ST-segment depression was most observed in leads Ⅲ、Ⅱ and aVF. All 6(100%) patients were with ST-segment depression in lead Ⅲ(mean 0.09±0.04 mV), 4 in lead Ⅱ, and 4 in lead a VF. Conclusions The ECG changes in AMI patients caused by occlusion of the first diagonal branch have the high prevalence of STsegment elevation in lead a VL with or without lead I and V2, and STsegment depresison in lead Ⅲ with or without lead Ⅱ and aVF.