心肌梗死的心电图鉴别诊断

ECG differential diagnosis of myocardial infarction

心电图是胸痛患者初期评估、早期危险分层、筛选和指导治疗中最常用、易行的诊断手段。心电图的改变是诊断急性心肌梗死的重要依据,它在诊断中扮演着不可或缺的角色,对心肌梗死的定性、病变部位的判断和病情的评估有着重要作用。但是,利用心电图诊断心肌梗死时,其敏感性及特异性存在一定的限制。有些心肌梗死患者的心电图无改变或改变不典型,而有些正常人或某些其他疾病的心电图表现酷似心肌梗死时心电图的变化。因此,在心肌梗死的心电图诊断中,应对心电图进行全面分析。本文对易与心肌梗死心电图相混淆的常见疾病伴随的心电图改变加以简述。

Electrocardiogram( ECG) is a diagnostic method frequently and easily applied in making preliminary assessment,risk stratification at early phase,screening,and treatment instruction for patients with pectoralgia. ECG changes serve as an important reference for the diagnosis of acute myocardial infarction,which plays an indispensable role in determining the nature of myocardial infarction,judging the diseased region,and evaluating the severity of the disease. However,there lie limits in sensitivity and specificity when ECG is utilized in diagnosing myocardial infarction. Part of myocardial infarction ECGs manifest no change or atypical changes while ECG changes exactly similar to those of myocardial infarction are found in ECGs of healthy people or cases with some other diseases. Therefore,it requires comprehensive analysis in ECG diagnosis of myocardial infarction. This paper briefly depicts ECG changes complicating common diseases,in order not to be confused with myocardial infarction ECG changes.