Transient QRS changes simulating acute myocardial infarction.
Transient QRS changes simulating acute myocardial infarction.
复制标题
模拟急性心肌梗死的瞬时 QRS 变化。
DOI：
10.1161/01.cir.62.5.975
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发表时间：
1980
期刊：
影响因子：
37.8
通讯作者：
Wagner,GS
中科院分区：
文献类型：
--
作者：
Hassett,MA;Williams,RR;Wagner,GS
本研究的目的是确定无法用急性心肌梗塞或左心室或右心室超负荷解释的异常初始 QRS 波力量突然发生的特征和发生率。对 3175 名疑似急性梗塞患者的计算机数据进行了审查，以确定那些在肌酸激酶和乳酸脱氢酶同工酶持续正常的情况下，心电图显示 QRS 波群被认为具有诊断意义的患者（Q 波或明显减弱的 R 波）。通过获得多空间描记和心向量图，最大限度地减少了导联错位。确定了 8 名患者 (0.25%)。 6 个导联异常受力仅限于 V 1-3 导联，1 个导联异常受力于 V 4-6，最后一个导联涉及所有心前导联。所有 8 名患者的这些 QRS 变化在 6 天内完全消失，这表明他们没有急性梗塞。这一理论得到了一名患者尸检的支持。据记录，这种综合征的发生率极低（0.25%），其特征是初始前力短暂丧失，同工酶谱持续正常。尽管无法确定病因，但八名患者中的七名可能是左束间隔束的短暂传导阻滞所致。
The purpose of this study was to determine the characteristics and incidence of abrupt occurrence of abnormal initial QRS forces that cannot be explained by acute myocardial infarction or left or right ventricular overload. Computerized data from 3175 patients with suspected acute infarction were reviewed to identify those in whom the ECGs revealed QRS complexes considered to be diagnostic (Q wave or markedly diminished R wave) in the presence of persistently normal profiles of both creatine kinase and lactic dehydrogenase isoenzymes. Lead misplacement had been minimized by obtaining multispace tracings and vectorcardiograms. Eight patients (0.25%) were identified. The abnormal forces were confined to leads V 1-3 in six, V 4-6 in one, and involved all precordial leads in the last. These QRS changes resolved completely within 6 days in all eight patients, which suggests that they did not have an acute infarction. This theory was supported by postmortem examination in one patient. An extremely low incidence (0.25%) has been documented for a syndrome characterized by transient loss of initial anterior forces with persistently normal isoenzyme profiles. Although no etiology could be determined, a transient conduction block of the septal fascicle of the left bundle could have been the cause in seven of the eight patients.