急性冠状动脉综合征中心电图微妙异常的病例报告,提示第一型心肌梗死。

Journal of education & teaching in emergency medicine Pub Date : 2023-04-30 eCollection Date: 2023-04-01 DOI:10.21980/J8W06X
Paige Matijasich, Patrick Bruss, Gregory Reinhold, Zachary Koppelmann
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引用次数: 0

摘要

本病例报告讨论了一名患者的心电图出现细微异常,表明其冠状动脉病变已达到病理程度,导致右冠状动脉(RCA)闭塞,尽管患者最初并未达到 STEMI 的 ST 段抬高标准。在适当的临床环境中,局灶性再极化异常与心脏危险因素和心脏症状相结合,可能表明冠状动脉病变的病理程度很高,需要进行紧急干预。我们报告了一例 54 岁男性急诊患者的病例,该患者有心脏危险因素和心脏症状。最初的心电图虽然技术上异常,但不能确诊。护理点肌钙蛋白升高至 0.10 纳克/毫升。患者最终被送往导管室,在那里他被发现RCA和左侧环状动脉闭塞,需要进行支架置入手术:心电图、心电图、心脏病学、心肌梗死。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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A Case Report of Subtle EKG Abnormalities in Acute Coronary Syndromes Indicative of Type One Myocardial Infarction.

This case report discusses a patient who had subtle EKG abnormalities that were indicative of a pathological amount of coronary artery disease resulting in occlusion of the right coronary artery (RCA) even though ST-elevation criteria for STEMI were not initially present. In the proper clinical setting, focal repolarization abnormalities in conjunction with cardiac risk factors and cardiac symptoms may indicate a high probability of a pathological amount of coronary disease that warrants emergent intervention. We report a case of a 54-year-old male with cardiac risk factors and cardiac symptoms who presented to the emergency department (ED). Initial EKG, while technically abnormal, was not diagnostic. The point of care troponin was elevated at 0.10 ng/mL. Patient ultimately went to the catheterization lab where he was found to have an occlusion of the RCA and left circumflex artery which required stenting.

Topics: Electrocardiogram, ECG, cardiology, myocardial infarction.

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