|
肥厚性心肌病心尖肥厚亚型的临床诊断 附28例临床报告 |
| |
周颖玲 李瑜辉 陈纪言 黄文晖 孙家珍
【摘要】 目的 对心尖肥厚型心肌病的辅助诊断进行探讨。方法 以心电图、超声心动图、放射核素心肌断层显像、冠状动脉造影及左室造影等检查方法，诊断28例心尖肥厚型心肌病。结果 28例心电图显示胸导联倒置的T波呈TV4＞TV5的关系；超声心动图左室心尖部(乳头肌水平以下)心肌肥厚达12mm以上；18例行放射核素心肌断层显像见左心室心尖部心肌肥厚；20例左心室造影均提示心尖部心肌肥厚、冠脉造影正常，其中11例左心室舒张末期呈“黑桃”样改变。结论 标准12导联心电图显示胸导联倒置的T波伴R波振幅增高，而不伴有高血压病史者，应高度注意心尖肥厚型心肌病的诊断。
【关键词】 心肌病，肥大性 心电描记术
Diagnosis of apical hypertrophic cardiomyopathy: A clinical report with 28 cases Zhou Yingling, Li Yuhui, Chen Jiyan, et al. Guangdong Provincial Cardiovascular Institute, Guangzhou 510100
【Abstract】 Objective The purpose of the study was to evaluate the value of ECG as compared with two-dimensional echocardiography for a reliable assessment of the clinical diagnosis of apical hypertrophic cardiomyopathy (AHCM).Methods and Results 28 cases (22 males, 6 females, mean age 51.50±13.45 years) with AHCM were studied by ECG, echocardiography, radionuclide 99mTc-MIBI myocardial scanning, coronary angiography and left ventriculography (LVG). ECG showed giant T wave inversion in chest leads. The amplitudes of inverted T wave were in the pattern or TV4>TV5. Left ventricular wall thickness measured by echocardiography were≥12mm in apex in 28 cases. Radionuclide myocardial scanning suggested apical hypertrophy in 18 cases. LVG demonstrated apical hypertrophic cardiomyopathy with normal coronary angiogram in 20 cases, 11 of which had the apical “spade” changes. Conclusion The character of inverted T waves of TV4＞TV5 in ECG is of major value on clinical diagnosis of those with AHCM.
【Key words】 cardiomyopathy, hypertrophic electrocardiography
心尖肥厚型心肌病(AHCM)的病变部位主要局限于左心室乳头肌以下的心尖部。此病在心电图、超声心动图和心脏造影有其特征的表现。现将1989年10月～1997年8月我院收治28例AHCM患者的资料报告如下。
资料与方法
本组28例AHCM，占同期收治肥厚型心肌病患者的26.5%。其中男22例，女6例，年龄21～72岁，平均51.50±13.45岁。临床表现：间歇性胸前区不适(包括胸闷、压榨样痛)23例，心悸9例，气促7例；体征：心脏听诊第一、二心音正常，有第四心音，心尖部吹风样收缩期杂音II/VI级6例。4例有肥厚型心肌病家族史，其中[1] [2] 下一页
上一个医学论文： 双心腔起搏治疗肥厚性梗阻型心肌病的临床应用及血液动力学观察
下一个医学论文： 心房扑动的心电生理特点及射频消融治疗
|
|
|
|
|
|
|
您现在的位置： 绿色健康网 >> 医学论文 >> 内科论文 >> 正文