不明原因晕厥伴λ波一例

Unexplained Syncope With theλPattern in Electrocardiogram:a Case Report

λ波是临床上少见的一种心电图标志,其出现常提示即将发生的致死性室性快速心律失常及心脏性猝死。在本例报告中,动态心电图记录了胸痛伴晕厥患者具有λ波改变继发进展性房室阻滞。λ波在胸痛时呈现,随后晕厥时记录到高度房室阻滞。冠状动脉造影检查示左回旋支狭窄。患者在罪犯血管内置入支架并服用相关药物预防冠状动脉痉挛后康复。此例表明在缺血性心脏病患者中λ波发生在高度房室阻滞诱导的晕厥之前。

Theλpattern is a rare electrocardiogram feature in clinical practice,which often indicates the occurrence of impending fatal ventricular tachyarrhythmias or sudden cardiac death.In this case,Holter monitoring recorded a progressive evolution of theλpattern followed by advanced atrioventricular blocks in a patient with chest pain accompanied by syncope.λsign occurred at the time of chest pain,and advanced atrioventricular blocks were recorded at the time of subsequent syncope.Coronary stenosis was detected in the left circumflex by coronary angiography.The patient recovered after stent implantation in the culprit vessel and related medications to prevent coronary spasm.Our case indicate that theλpattern could occur prior advanced atrioventricular blocks-induced syncope in patient with ischemic heart disease.