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病例分享：急性心包炎的心电图诊断

2018-03-28 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

急性心包炎心电图诊断
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1例42岁男性，左侧胸部锐痛伴呼吸困难3小时。心电图如下。

1例42岁男性，左侧胸部锐痛伴呼吸困难3小时。心电图如下。



心电图诊断：1.窦性心动过速；2.心率110次/分；3.急性心包炎。

【评述】

1.该患者心电图呈弥漫性ST段抬高，应考虑急性心包炎、大面积心肌梗死、室壁瘤、早期复极化综合征和冠状动脉痉挛等情况。而此份心电图ST段抬高呈凹面向上，同时合并PR段下移，最明显表现在下壁导联（Ⅱ、Ⅲ、aVF导联）PR段下移，这是急性心包炎高度特异性的心电图改变。

2.此外，该心电图还表现有aVR导联PR段抬高、ST段压低。aVR导联PR段抬高常常提示急性心包炎，但并不特异，有些心梗也会表现有aVR导联PR段抬高。若aVR导联PR段抬高合并ST段压低同时出现，有助于急性心包炎的特异性诊断，这种心电图表现称为急性心包炎的“互惠”现象。

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    2018-03-30 changjiu

    谢谢分享学习一下

    0

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    2018-03-30 zhao4617

    #心包炎#

    0

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    2018-03-29 飛歌

    学习了很有用

    0

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    2018-03-29 wzb521zf

    一起学习学习

    0

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    2018-03-29 张新亮1853311252142e2fm

    鉴别诊断.很实用

    0

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