摘要
目的分析和总结应激性心肌病的临床和影像学特征。方法对确诊的10例应激性心肌病患者,分析其病史、症状、心电图、超声心动图、冠状动脉和左心室造影及核素心肌显像结果。结果患者多有受过心理打击等应激因素;可表现为突发胸闷、胸痛等症状;心电图部分表现为胸导联ST段抬高、T波倒置,较少出现病理性Q波;心肌酶正常或轻度升高;选择性冠状动脉造影未发现对应的冠状动脉病变;左心室造影和超声心动图示左室射血分数降低,可有室壁瘤形成;核素心肌显像检查示相应区域灌注和代谢不匹配,提示心肌存活;心电图改变及左室功能多较快恢复。结论应激性心肌病易被误诊为急性心肌梗死,核素心肌显像能够提示病变区存活心肌,有助于两者的鉴别。
Objective To analyze and summarize the clinical and imaging features of stress cardiomyopathy.Methods It was analyzed that the medical history,symptoms,electrocardiogram,echocardiography,and results of coronary arteriography,left ventriculography and nuclide myocardial imaging of 10 cases who were diagnosed as stress cardiomyopathy.Results Mental strike was the main stress factor among these patients.The symptoms included accidental chest distress and chest pain,etc.Part of the electrocardiogram showed elevation of chest lead ST segment and inversion of T wave,and pathological Q wave was rarely seen.Normal or slightly elevating cardiac enzymes were found.No corresponding coronary artery disease was found by selective coronary arteriography.Left ventriculogram and echocardiography showed decrease of left ventricular ejection fraction,and ventricular aneurysm might occur.The nuclide myocardial imaging showed mismatch of perfusion and metabolism in corresponding region,which indicated the presence of viable myocardium.There were changes in the electrocardiogram,and most patients’ left ventricular function recovered rapidly.Conclusion Stress cardiomyopathy is likely to be misdiagnosed as acute myocardial infarction.Nuclide myocardial imaging can indicate the presence of viable myocardium in diseased region,and help to identify the two diseases above.
出处
《西南国防医药》
CAS
2012年第3期275-277,共3页
Medical Journal of National Defending Forces in Southwest China
关键词
应激性心肌病
临床特点
影像学特征
stress cardiomyopathy
clinical feature
imaging feature
