A 72-year-old elderly male smoker with a known history of hypertension presented with a six day history of chest pain. His blood pressure at presentation was 110/70 mmHg and there was no audible murmur. ECG showed Q w...A 72-year-old elderly male smoker with a known history of hypertension presented with a six day history of chest pain. His blood pressure at presentation was 110/70 mmHg and there was no audible murmur. ECG showed Q waves in the inferior leads (Figure IA) and troponin level was elevated (14 /.tg/L).展开更多
文摘A 72-year-old elderly male smoker with a known history of hypertension presented with a six day history of chest pain. His blood pressure at presentation was 110/70 mmHg and there was no audible murmur. ECG showed Q waves in the inferior leads (Figure IA) and troponin level was elevated (14 /.tg/L).
文摘目的对比左室造影与超声心动图对心尖肥厚型心肌病的诊断价值。方法对12例心尖肥厚型心肌病患者(男10例,女2例)进行左室造影、超声心动图、心电图及冠状动脉造影等检查。结果 12例患者左室造影均显示左室腔呈"黑桃A"型(ace of spades),而心脏超声检查仅1例明确提示心尖部心肌肥厚;10例患者体表心电图提示左胸导联倒置T波。结论心脏超声诊断心尖肥厚型心肌病敏感性低;特征性心电图表现(左胸导联巨大倒置T波)对于心尖肥厚型心肌病诊断有提示意义;对于临床怀疑心尖肥厚型心肌病的患者在冠状动脉造影排除冠心病后可行左室造影以确诊。