右胸导联V4R和V5R对由右冠脉近段阻塞引起的急性ST段抬高型心肌梗死的诊断价值

目的与右冠脉阻塞关联的ST段抬高型右室心肌梗死,住院期死亡率高。本研究假设是:右胸导联(V4R和V5R导联)有助于发现ST段抬高型右室心肌梗死。1342例患者记录12导联加右胸导联心电图。结果右冠脉近段阻塞者,V4R和V5R导联常见有ST段抬高,同时伴有Ⅰ,aVL,V5和V6导联ST段压低;常规12导联心电图通常不能发现ST段抬高。结论对于急性冠脉综合征,提高对ST段抬高型心肌梗死诊断的敏感性,常规12导联附加右胸导联是一项简便的方法。

Right precordial leads V4R and V5R in ECG detection of acute ST elevation MI associated with proximal right coronary artery occlusion

Objective ST elevation myocardial infarction(STEMI)in the right ventricle (RV)associated with right coronary artery(RCA) occlusion is known to have high hospital mortality. The hypothesis tested in this study is:right precordial leads V4R and V5R help to detect STEMI in the right ventricle. ECGs from 1342 subjects were collected in Ruijin Hospital. All ECGs were recorded with additional leads on the right precordial location in V4R and V5R. Our results showed that the subjects with middle to upper RCA occlusion often show ST elevation in leads V4R and V5R and ST depression in lateral leads I, aVL, V5-V6, and ST elevation is often undetected as STEMI or AMI in the standard 12-lead ECG. We conclude that adding V4R and V5R to standard ECG is an easy and convenient way in assessing patients presenting with acute coronary syndrome, to increases the sensitivity of STEMI detection.