急性左室梗塞时右胸导联ST段抬高的临床意义

研究目的评价急性左室梗塞时右胸导联ST段抬高对合并右室梗塞的诊断意义。处理方法右胸导联(V_3R～V_5R)ST段抬高的界定为于J点后0.04秒处测量,自等电位线上移≥0.1mv被认为有意义。抬高类型参照Kataoka分类法。右室梗塞的诊断用非侵入性方法进行诊断。结果所研究的23例中,9例表现为右胸导联ST段抬高,其中3例符合右室梗塞的诊断标准,无右胸导联ST段抬高者14例,其中13例无右室梗塞表现,另1例不能确定。结论急性左室下壁梗塞时右胸导联ST段抬高对合并右室梗塞的诊断有重要价值。左室前壁梗塞时出现右胸导联ST段抬高,诊断合并右室梗塞需慎重分析。

Clinical significance of ST elevation in the right chest leads in acute left ventricular infarction

Study Objective To evaluate the significance of the ST elevation in the right chest leads for the diagnosis of complicated right ventricular ( RV) infarction in the presence of acute left ventricular (LV) infarction. Interventions The study group consisted of 23 patients with acute myocardial infarction (AMI), 18 were men and 5 women; Their average age was 54.1 years ( range 36 to 78) . The diagnosis of AMI was established on the basis of characteristic history ,electrocardiographic changes and elevation in cardiac enzymes. The ST shift in the right chest leads (V3R to V5R) was measured at 0.04 second after the J point and the ST el-evation>0.1 mv was considered significant. The pattern of ST elevation in the right chest leads was classified according to Kataoka's method. The diagnosis of RV infarction was established through noninvaded methods. Results Of the 23 patients studied, 9 patients presented ST elevation in the right chest leads, three of which were possessed of criteria for the diagnosis of RV infarction. 13 of 14 patients presenting no ST elevation in the right chest leads lacked evidence of RV infarction. The diagnosis of other patient was not definite. Conclusion The ST elevation in the right chest leads was significant in the diagnosis of complicated RV infarction in inferior wall left ventricular acute myocardial infarction, but it should be analysed carely in anterior wall left ventricular infarction.