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急性心肌梗塞合并心脏破裂有三种情况:①心室游离壁破裂;②室间隔穿孔;③乳头肌断裂。1.心脏破裂时心电图所见(1)London 氏报告心脏破裂时,表现为胸部导联高尖T 波或倒置的T 波转为直立T波。原因可能为心脏的搅拌作用使红细胞急速溶血,心肌外层钾离子浓度增加,心包内压急骤上升,使心外膜下层受压,而引起局部缺血性变化。(2)Friedman 氏报告心脏破裂时心电图变化是:QRS 波电压低下,深的倒置T 波及ST 改变(上升或下降),并用狗做实验证明
There are three cases of acute myocardial infarction with heart rupture: ① ventricular free wall rupture; ② ventricular septal perforation; ③ papillary muscle rupture. 1. Electrocardiogram seen at heart rupture (1) London’s report of heart rupture showed a T-wave at the tip of the thoracic curve or inverted T-wave to an upright T-wave. The reason may be the role of the heart agitation rapid hemolysis of red blood cells, myocardial outer potassium concentration increased, a sudden increase in pericardial pressure, the epicardial pressure, resulting in ischemic changes. (2) Friedman’s report of electrocardiographic changes on heart rupture was: low QRS wave voltage, deep inverted T wave and ST changes (up or down), and experiments with dogs