简介:目的探讨酷似急性心肌梗死(AMI)的急性重症病毒性心肌炎(AFVM)的诊断和治疗。方法收集临床表现酷似心肌梗死(MI),经过冠状动脉造影(CAG)显示冠脉正常的AFVM14例,分析该病的发病机制、心电图特征、治疗及预后。结果经及时确诊并采取相应治疗后4例乏力、胸痛、心悸、气短等症状明显好转,心肌酶、心电图及心脏彩超恢复大致正常范围;2例发生阵发性心悸,发作时心电图示:非阵发性室性心动过速及室上性心动过速,室性期前收缩;4例发作性胸闷、胸痛,心电图示:ST-T改变(ST段下移0.1~0.2mV,T波低平伴切迹);1例心电图示三度房室传导阻滞;1例呈左束支传导阻滞;1例显示病理性Q波;l例因急性期而死亡。结论酷似MI的病毒性心肌炎其临床表现、心电图、心肌酶改变酷似AMI。着重把握临床资料,掌握客观诊断依据,积极合理诊治是值得临床医生重视的问题。
简介:目的观察心肌梗死急诊经皮冠状动脉介入(PCI)治疗的疗效及安全性.方法对14例急性ST段抬高心肌梗死(STEMI)患者在发病12h内行急诊PCI.其中急性前壁、急性前间壁心梗10例,急性下壁心梗4例.结果14例患者中,冠脉造影显示梗死相关动脉(IRA)为前降支8例,回旋支3例,右冠脉4例,13例患者(92.9%)介入治疗获得成功,置入支架15枚,全部获得TIMI血流3级.1例因术中发生室颤,经除颤转为窦性心律后家属放弃手术未能成功.结论对急性STEMI患者行急诊PCI治疗是积极有效的,安全性高,能明显提高患者生活质量,降低住院死亡率.
简介:AbstractAnagedmalepatientwithcoronaryheartdiseasewhichhadbeentreatedwithcoronaryarterybypassgrafts(CABG)andadministrationofmetoprolol,presentedparoxysmalvertigointhepreviousthreeweeks.The24hourssynchronic12-leaddynamicelectrocardiography(DCG)revealedmanyepisodesofsinusarrestwhichmostlywerefollowedbyA-Vjunctionalorventricularescaperhythm,thelongestsinuspauselastingmorethan14.5secondswithnosymptom.Afterwithdrawalofmetoprolol,theDCGrevealedmuchlessepisodesofsinusarrestthanon-admission,butstillsomeA-Vjunctionalandventricularescapebeats.Sicksinussyndromeswasthendiagnosed,andasynchronousdual-chamberpacemaker(DDDR)wasimplantedtwoweeksafteradmission.