AMI(双心室起搏)-不要丢弃心电图。

IF 1.6 4区 医学 Q2 Medicine Acta Clinica Belgica Pub Date : 2023-04-01 DOI:10.1080/17843286.2022.2074711
T Versyck, D Devriese, S Smith, P Calle, C Borin
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引用次数: 0

摘要

背景:越来越多的室性心律失常患者以胸痛就诊于急诊室。st段抬高型心肌梗死(STEMI)的诊断和随后的经皮冠状动脉介入治疗(PCI)常常被推迟,因为12导联心电图(ECG)因不可解释而被丢弃。越来越多的文献表明,Smith-modified Sgarbossa标准可用于有节奏节律的STEMI患者的诊断。这些标准最初是为了解释左束支传导阻滞(LBBB)和胸痛患者的心电图而制定的,但已经扩展到有节奏的心电图。方法:我们提出三个胸痛和右心室或双心室起搏的病例报告。结果:在所有三个病例中,Smith-modified Sgarbossa阳性,STEMI的诊断可以在早期做出。意义:寻找st段偏差并将有症状的心电图与以前无症状的心电图进行比较仍然很重要。由于潜在急性心肌梗死(AMI)和节律性心律的患者数量在未来可能会增加,急诊医生和心脏病专家应该了解这些标准。
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AMI in (bi)ventricular pacing - do not discard the ECG.

Background: There is a growing number of patients with ventricular paced rhythm, who present to the emergency department with chest pain. The diagnosis of ST-segment elevation myocardial infarction (STEMI) and subsequent percutaneous coronary intervention (PCI) is often postponed, as the 12 leads-electrocardiogram (ECG) is discarded as not interpretable. There is a growing body of literature that suggests that Smith-modified Sgarbossa criteria can be applied for the diagnosis of STEMI in patients with paced rhythms. These criteria were originally developed for the interpretation of ECGs in patients with a left bundle branch block (LBBB) and chest pain, but have been expanded to paced ECGs.

Methodology: We present three case reports with chest pain and right ventricular or biventricular pacing.

Findings: In all three cases, the Smith-modified Sgarbossa was positive and the diagnosis of STEMI could have been made early on.

Implications: It remains important to look for ST-segment deviations and to compare the symptomatic ECG with previous asymptomatic ECGs. As the number of patients with potential acute myocardial infarction (AMI) and paced rhythms is likely to rise in the future, these criteria should be known to emergency physicians and cardiologists.

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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica 医学-医学:内科
CiteScore
2.90
自引率
0.00%
发文量
44
审稿时长
6-12 weeks
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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