病理性Q波的临床意义

目的探讨心电图有缺血分布区的病理性Q波的病因及临床意义。方法对30例因胸痛、心前区不适、心电图有缺血分布区的病理性Q波患者(已确诊为心肌梗死者、心力衰竭、预激综合征除外)行冠状动脉造影检查。结果肥厚型心肌病15例，冠状动脉正常1例，先天性左房室瓣前叶裂合并轻度左房室瓣返流1例，冠心病7例(1例为高血压合并冠心病)，单纯高血压7例(均有心肌肥厚)。结论当心电图出现有缺血分布区的病理性Q波，而患者无确切的心肌梗死病史，应先行心脏彩色超声检查；只有在有典型的心绞痛患者，才应行冠状动脉造影术。

Analysis of factors in patients with pathological Q wave

Objective The purpose of this study was to discuss the factors of pathological Q wave in patients with an extent of myocardial ischemia and observe what diseases are related to the change of pathological Q wave in 12 lead ECG.Methods The coronary angiography(CAG) was performed in 30 patients with chest pain,chest discomfort and pathological Q wave in 12 lead ECG,with an exception of confirmed diagnoses of myocardial infarction,heart failure and pre-excitation syndrome,this kind of Q wave has an extent of myocardial ischemia.Results In the 30 patients,significant diseases were found,HOMC is diagnosed in 15 cases(CAG is abnomal),CHD is diagnosed(significant stenosis was found) in 6 patients,HBP is 8 cases(significant stenosis was found 1 case),and 1 patient has MR,1 patient is not abnomal in body.Conclusions Pathological Q wave is not the only standard to diagnose myocardial infarction.Significant stenosis was an uncommon finding during CAG in those patients without episodes of AMI(acute myocardial infarction )and at first,those patients must do Echocardiography.Only in patients with angina,CAG is feasible.