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病例分享:早期复极综合征的心电图诊断与鉴别

2018-03-07 江苏省人民医院 卢妙 许迪 黄元铸 中国医学论坛报今日循环

1例22岁男性患者,抬举重物后自觉胸痛。

1例22岁男性患者,抬举重物后自觉胸痛。



心电图诊断

1. 窦性心律不齐;2. 心率66次/分;3. 早期复极综合征。

评述

1. 窦性心律不齐的定义为:①窦性心律;②心率变异(RR间期差异>0.12秒)。窦性心律不齐通常发生在心率较慢时(<70次/分钟)。

2. 早期复极综合征是一种正常变异,在年轻健康成年人中常见,尤其是男性。患者会出现多导联ST段抬高,最常见是胸前导联(V2、V3和V5),但ST段抬高不会出现在aVR或V1导联中。J点将随着ST段的抬高而抬高,以维持ST段的形态。

3. 早期复极综合征需注意与急性ST段抬高型心肌梗死相鉴别。前者ST段抬高是凹面向下的,这是与急性ST段抬高型心肌梗死鉴别诊断的特征。

4. 早期复极综合征还需与急性心包炎鉴别诊断,但鉴别诊断较困难,不同导联中PR段压低有利于急性心包炎的诊断。然而,这两者之间的区别往往要根据患者的病史和体格检查来确定:急性心包炎通常与胸膜炎的剧烈胸痛有关,而这些患者在心脏听诊时可能听到心包摩擦音。

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    2021-07-26 零文芬

    学习了谢谢

    0

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    2021-04-11 ms5000001710450087

    学习了,谢谢

    0

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    2018-03-07 changjiu

    学习一下谢谢

    0

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