心室分离2例

例1 患者女,54岁。临床诊断:原发性高血压Ⅲ期,高血压心脏病合并冠心病,左侧心力衰竭。以往超声心动描记术显示左心室后壁增厚及运动减弱、室间隔增厚,心电图有左前分支阻滞及频发室性期前收缩。入院时BP26/16kPa(195/120mmHg)。1h后病人突然呼吸困难、大汗、烦燥、口唇发绀。体检:BP29/18kPa(217/135mmHg),两下肺可闻及湿性啰音,心率快,律不齐,有室性奔马律。立即静脉注射利多卡因100mg,约2min后异位激动波消失,后经扩血管降压、强心、利尿等处理,0.5h后血压基本恢复正常,病情平稳。常规治疗2周痊愈出院。抢     

硝酸酯治疗对心室重构和心室功能的影响

本文从病理生理学角度阐述急性心梗后早期和持续应用硝酸甘油对防止和减轻左室重构，维持左室功能的作用，并介绍了目前已完成的几个有意义的实验临床研究。     

心室分离1例

患者男,63岁。临床疑诊急性心肌梗死,入院12h后突发心脏骤停,复苏抢救过程中描记心电图(图1)。图为Ⅱ导联非连续记录,上行前部可见频率为154次／min左右高低不等的心室颤动波,并在长达4．46s的时间内未见其它QRS波,上行后部缓慢出现3个宽大畸形的QRS波,考虑为室性逸搏心律,但室颤波仍然存在,两者相互重叠。下行室颤波电压波动更大,时而变得十分纤细,难以辨认,但频率变化不     

急性心肌梗死致心室分离1例

患者男性，50岁。临床诊断：急性心肌梗死（广泛前壁），心功能Ⅲ。入院当口患者突然烦躁不安，自诉心悸、胸闷，随即出现阵发性抽搐，神志不清，血压测不到。急查心电图显示（图1A）：心室有两个节律点活动，一种为振幅规则，间距相等的心室扑动波，频率为215bpm，在此同时出现另一种心室自主心律，QRS波群明显增宽（〉0.20s），频率较为缓慢为50bpm。     

心室分离

患者男性,78岁,因反复咳痰18年,胸闷、气短5年,胸痛2d于200年7月12日入院。临床诊断为慢性气管炎急性发作,肺源性心脏病,呼吸衰竭三级。入院后体     

心肌病合并心室分离二例

例1患者早期为肥厚非梗阻性心肌病,后演变为扩张型心肌病,心电图QRS逐渐增宽,并演变为"双QRS"。例2患者为肥厚非梗阻性心肌病,心电图由早期的预激综合征、室性早搏、室性心动过速、室上性心动过速、完全性左束支传导阻滞演变为心室分离。     

磷霉素过敏致心室分离1例

患者女性 ,５０岁。因反复关节酸痛、心悸、乏力３４年 ,再发伴发热１５天入院。入院诊断 :风湿性心脏病 ,二尖瓣狭窄伴关闭不全 ,急性细菌性心内膜炎 ,心功能Ⅲ级。入院后给予强心利尿治疗 ,并予磷霉素抗炎 ,在静滴磷霉素５ｍｉｎ后出现呼吸困难、胸闷、心前区疼痛 ,伴大汗淋漓、呕吐。体检 :ＢＰ５．３／０ｋＰａ(４０／０ｍｍＨｇ)。心率３００次／ｍｉｎ ,心律不齐。两下肺可闻及湿音。立即予地塞米松１０ｍｇ静脉注射 ,肾上腺素１ｍｇ肌肉注射及多巴胺、利多卡因静脉滴注 ,０．５ｈ后血压恢复正常。抢救过程中心电图连续描记先示尖端…     

同源性心室分离一例

患者女性,50岁。因胸闷、气促、心悸、双下肢水肿1年,加重1周就诊,临床诊断为扩张型心肌病。心电图示:窦性心律,心率60次/分,QRS波群极度增宽而畸形,时间达0.26s,QRS波群终末部有一酷似P′波的特殊波形;电轴-49°。1年后复查心电图与1年前基本一致,食管心房快速起搏(S1S2法,120次/分),图形无明显变化,考虑为同源性心室分离。     

同源性心室分离1例

同源性心室分离是一种临床少见、具有特征性心电图表现的室内阻滞。一定程度的心室除极分离化是其主要产生机制。现报告一例29岁先心病室间隔缺损的同源性心室分离心电图,并简要阐述其病因、心电图特征以及平台波形成机制。     

经冠状动脉自体骨髓单个核细胞移植治疗扩张型心肌病1例

1 病例资料 病人,男,农民,52岁,因反复胸闷气促5年加重2周入院.病人5年前起病,活动后气促、胸闷,双下肢水肿,多次心电图示:偶发室性期前收缩,ST-T改变;全胸片示:心影扩大,外院诊断冠心病,长期口服硝酸酯类药物和噻嗪类利尿剂治疗.     

室间隔缺损修补手术1319例分析

目的总结1319例室间隔缺损(VSD)修补手术的临床结果与体会。方法2000年1月至2005年8月对1319例VSD患者行修补手术,男791例,女528例,年龄2个月~40岁。其中婴儿111例,体重6.0kg以下26例。全组均在全身麻醉低温体外循环下行VSD修补术,105例合并其它畸形同期矫治。结果术后30d内死亡6例(病死率0.45%),出现并发症88例(发生率6.67%),随访1203例无远期死亡,效果满意。结论VSD修补术安全可靠,效果好。     

Ventricular tachycardia with two variable foci

Summary Torsades de pointes results from a ventricular tachycardia with two variable foci, and when considered in detail, can be differentiated from patterns of bulging of ventricular fibrillation. Episodes of bulging electrical activity seen during complete His bundle block are therefore not due to ventricular fibrillation, although they can degenerate into ventricular fibrillation. The existence of a spontaneously reversible ventricular fibrillation in normothermic conditions in humans can only be established with concurrent synchronized recordings. The very important phenomenon of the interruption of coordinated activation during reoxygenation and rewarming requires further study. The progressive variations of signal amplitude result from the activity of at least two simultaneous phenomena.Reprinted from Dessertenne (Arch, Mal Coeur 1966;2:263–272)This article is reprinted from the original by permission of the journal and, where appropriate, the authors. No reprints are available.     

Leprosy in infants--report of two cases

Two infants, one 4 months old and the other 2 months old, having histologically confirmed indeterminate leprosy are reported. The route of infection, mode of transmission, and incubation period are discussed with reference to these two cases of infantile leprosy.     

植入型心律转复除颤器治疗两例患者

心脏性猝死以室性心动过速(室速)、心室颤动(室颤)引起者占82%以上.多个大规模临床试验已经证明植入型心律转复除颤器(ICD)降低室性心律失常病人死亡率的效果明显优于抗心律失常药物.ICD术后辅以相应的抗心律失常药物可减少快速心律失常的发生.     

Ventricular septal defect in infancy: Detection with two dimensional echocardiography

To determine the sensitivity and specificity of two dimensional echocardiography in detecting ventricular septal defect two dimensional echocardiograms were performed on 53 infants under 1 year of age. The diagnosis of ventricular septal defect was confirmed by cardiac catheterization in 27 patients; an intact ventricular septum was confirmed by catheterization in 18 and clinically in 8. Using a 35 ° mechanical sector scanner with a 3.5 megahertz transducer, we imaged the ventricular septum in the long axis and in a four chamber view (apical or subcostal, or both). Images were recorded on videotape and reviewed independently by two observers unaware of the diagnosis. Interobserver agreement was 94 percent. Among the 27 patients with a ventricular septal defect, the lesion was correctly identified in 20 (74 percent) and was undetected in 7 (3 of whom had a defect less than 4 mm in diameter, as determined by angiography). No defect less than 4 mm in diameter was detected. Among the 26 patients with an intact septum, a defect was correctly excluded in 23 (88 percent); a false positive diagnosis was made in 3. The apical and subcostal views demonstrated the greatest number of defects (20 of 20), but also gave the highest number of false positive diagnoses (3 of 3). The long axis view was helpful when positive, but showed only 9 of 20 of the defects.In this study, two dimensional echocardiography detected approximately three fourths of ventricular septal defects large enough to warrant cardiac catheterization in the 1st year of life. False positive diagnoses were related to dropout of echoes in the membranous septum when imaged in the four chamber views.