左前下垂冠状动脉T波逆转模式 (威伦斯综合征) 与心肌炎和正常的左冠状动脉相关
Geeta Bhagia1, Nasir Hussain2, Fnu Arty3
1Rochester General Hospital, Rochester, USA.
概括
这一案例突出显示,心肌炎可以模仿韦伦斯综合征,心电图 (EKG) 图案通常表明临界左前下降动脉狭窄. 临床医生应考虑肌心炎在这个心电图发现的差异诊断.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 威伦斯综合征,以特定的心电图发现为特征,通常与关键左前下降动脉狭窄有关.
- 韦伦斯心电图模式与心肌炎之间的关联在医学文献中以前没有被描述过.
- 本报告介绍了一个罕见的案例,说明了这种不寻常的联系.
研究的目的:
- 报告一个罕见的韦伦斯心电图 (EKG) 模式在被诊断为心肌炎的患者.
- 扩大威伦斯心电图模式的差异诊断,超出临界LAD狭窄.
- 强调在患有Wellens'心电图发现的患者中考虑心肌炎的重要性.
主要方法:
- 一个31岁的女性病例报告,胸痛和心电图异常.
- 电心电图 (EKG) 的解释,高灵敏度的热素水平,以及红细胞沉积率的测量.
- 心脏导管和心脏磁共振 (CMR) 影像用于诊断.
主要成果:
- 患者表现出胸痛和心电图发现与韦伦斯模式一致.
- 心脏导管检查显示没有显著的LAD狭窄,排除了威伦斯综合征的典型原因.
- 心脏磁共振成像 (CMR) 证实了心肌炎作为诊断,没有证据表明心肌梗塞.
结论:
- 威伦斯心电图模式,虽然高度特定于关键的LAD狭窄,也可以与其他心脏状况相关.
- 肌心脏炎应在患有威伦斯心电图模式的患者的差异诊断中考虑.
- 这一案例强调了在解释暗示威伦斯综合征的心电图发现时需要全面的诊断评估的必要性.
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