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老年人心尖肥厚型心肌病的临床特点

Clinical characteristics of apical hypertrophic cardiomyopathy in the elderly
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摘要 目的 了解老年人心尖肥厚型心肌病的临床特征及正确诊治方法。方法 分析7例老年心尖肥厚型心肌病患者的临床表现和心电图、超声心动图、心室造影及冠状动脉(冠脉)造影等检查特点,总结老年心尖肥厚型心肌病临床特征。结果 6例出现胸闷、胸痛,4例心界向左侧扩大,2例可闻第四心音。心电图显示胸导为主导联上R波增高、ST段压低及对称性T波倒置,5例经超声心动图证实心尖处心肌肥厚,5例左心室造影时呈“黑桃”样图形,1例冠脉造影有轻度狭窄。结论 老年人心尖肥厚型心肌病多属于黑桃型,可并存冠脉病变。心电图、超声心动图、心室造影及冠脉造影等检查有助于该病的诊断。 Objective To analyze the clinical features of apical hypertrophic cardiomyopathy (AHCM) in the elderly and to evaluate the significance of ECG or other accessory examinations. Methods Seven elderly patients with AHCM C5 males and 2 females, mean age (65. 1±4. 2) years] were studied through clinical features, ECG, echocardiography, coronary angiography (CAG) and left ventriculography (LVG). Results Six patients suffered from chest pain or discomfort, 4 were with heart enlargement, 2 had audible S4. All patients showed tall R waves voltage, ST segment depression and symmetry T waves inversion in the precordial leads of ECG, only 3 had giant negative T waves (GNT). Echocardiography confirmed abnormal thickening of left ventricular apical myocardium in 5 patients. LVG showed an end-diastolic appearance of left ventricular cavity similar to that of 'ace of spades', the apex was obliterated in systole in all 5 patients, and CAG demonstrated 1 patient with mild coronary artery stenosis. Conclusions Most of elderly patients with AHCM are in the type of spade-like configuration, and some patients may coexist with coronary artery lesions. ECG, echocardiography, CAG and LVG are useful to identify the AHCM in the elderly.
出处 《中华老年医学杂志》 CAS CSCD 北大核心 2003年第8期453-456,共4页 Chinese Journal of Geriatrics
关键词 老年人 心尖肥厚型心肌病 临床特点 心电图 超声心动图 心室造影 Cardiomyopathy, hypertrophic Electrocardiography Echocardiography
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