病例分享:早期复极综合征的心电图诊断与鉴别

2018-03-07 江苏省人民医院 卢妙 许迪 黄元铸 中国医学论坛报今日循环

1例22岁男性患者,抬举重物后自觉胸痛。

1例22岁男性患者,抬举重物后自觉胸痛。



心电图诊断

1. 窦性心律不齐;2. 心率66次/分;3. 早期复极综合征。

评述

1. 窦性心律不齐的定义为:①窦性心律;②心率变异(RR间期差异>0.12秒)。窦性心律不齐通常发生在心率较慢时(<70次/分钟)。

2. 早期复极综合征是一种正常变异,在年轻健康成年人中常见,尤其是男性。患者会出现多导联ST段抬高,最常见是胸前导联(V2、V3和V5),但ST段抬高不会出现在aVR或V1导联中。J点将随着ST段的抬高而抬高,以维持ST段的形态。

3. 早期复极综合征需注意与急性ST段抬高型心肌梗死相鉴别。前者ST段抬高是凹面向下的,这是与急性ST段抬高型心肌梗死鉴别诊断的特征。

4. 早期复极综合征还需与急性心包炎鉴别诊断,但鉴别诊断较困难,不同导联中PR段压低有利于急性心包炎的诊断。然而,这两者之间的区别往往要根据患者的病史和体格检查来确定:急性心包炎通常与胸膜炎的剧烈胸痛有关,而这些患者在心脏听诊时可能听到心包摩擦音。

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1002738, encodeId=eb671002e38a2, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210601/37aba592e33e4fd9929e9499117ced47/9817f8e370ac4345b14d09dac5df06ea.jpg, createdBy=abbe5506745, createdName=零文芬, createdTime=Mon Jul 26 14:48:03 CST 2021, time=2021-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956013, encodeId=659c95601365, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11c35456864, createdName=ms5000001710450087, createdTime=Sun Apr 11 21:47:37 CST 2021, time=2021-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431141, encodeId=d39d1431141af, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Mar 09 11:26:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293927, encodeId=c48329392e27, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Wed Mar 07 20:36:26 CST 2018, time=2018-03-07, status=1, ipAttribution=)]
    2021-07-26 零文芬

    学习了谢谢

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1002738, encodeId=eb671002e38a2, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210601/37aba592e33e4fd9929e9499117ced47/9817f8e370ac4345b14d09dac5df06ea.jpg, createdBy=abbe5506745, createdName=零文芬, createdTime=Mon Jul 26 14:48:03 CST 2021, time=2021-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956013, encodeId=659c95601365, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11c35456864, createdName=ms5000001710450087, createdTime=Sun Apr 11 21:47:37 CST 2021, time=2021-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431141, encodeId=d39d1431141af, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Mar 09 11:26:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293927, encodeId=c48329392e27, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Wed Mar 07 20:36:26 CST 2018, time=2018-03-07, status=1, ipAttribution=)]
    2021-04-11 ms5000001710450087

    学习了,谢谢

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1002738, encodeId=eb671002e38a2, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210601/37aba592e33e4fd9929e9499117ced47/9817f8e370ac4345b14d09dac5df06ea.jpg, createdBy=abbe5506745, createdName=零文芬, createdTime=Mon Jul 26 14:48:03 CST 2021, time=2021-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956013, encodeId=659c95601365, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11c35456864, createdName=ms5000001710450087, createdTime=Sun Apr 11 21:47:37 CST 2021, time=2021-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431141, encodeId=d39d1431141af, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Mar 09 11:26:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293927, encodeId=c48329392e27, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Wed Mar 07 20:36:26 CST 2018, time=2018-03-07, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1002738, encodeId=eb671002e38a2, content=学习了谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210601/37aba592e33e4fd9929e9499117ced47/9817f8e370ac4345b14d09dac5df06ea.jpg, createdBy=abbe5506745, createdName=零文芬, createdTime=Mon Jul 26 14:48:03 CST 2021, time=2021-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956013, encodeId=659c95601365, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11c35456864, createdName=ms5000001710450087, createdTime=Sun Apr 11 21:47:37 CST 2021, time=2021-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1431141, encodeId=d39d1431141af, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Mar 09 11:26:00 CST 2018, time=2018-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=293927, encodeId=c48329392e27, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Wed Mar 07 20:36:26 CST 2018, time=2018-03-07, status=1, ipAttribution=)]
    2018-03-07 changjiu

    学习一下谢谢

    0

相关资讯

JAHA:早期复极综合征患者冠状动脉痉挛诊断的意义!

由此可见,大约40%的CAS患者在没有经历胸部症状的首次VF时存在VF和下壁J波,并且有可能被误诊为ERS。使用痉挛激发试验被认为是区分病人进行最佳治疗的必要条件。