【摘 要】
：
例1 男,45岁,因劳累后心慌、气促1个月就诊.体检:T 36.9℃,P 96 次/min,BP 120/70 mmHg(1 mmHg=0.133 kPa).心尖搏动位于右侧第5肋间锁骨中线内侧,心率96次/min,律齐,无杂音,
【机 构】
：
解放军71345部队医院内科,解放军71345部队医院心电图室
论文部分内容阅读
例1 男,45岁,因劳累后心慌、气促1个月就诊.体检:T 36.9℃,P 96 次/min,BP 120/70 mmHg(1 mmHg=0.133 kPa).心尖搏动位于右侧第5肋间锁骨中线内侧,心率96次/min,律齐,无杂音,双肺呼吸音清,无干湿音.X 线示主动脉结位于右侧,右心缘相当于左心室的弧度,胃泡在右侧膈下.腹部B超示肝脾脏换位,肝脏位于左侧,脾脏位于右侧.心电图检查:P波按规律发生,PaVR、V3、5双向,I及aVL导联的P-QRS-T呈倒置波群,aVR导联正向,aVF导联与正常相似,自V1～5都是主波向下的rS或QS波群,R波逐渐减小,S波逐渐相对增深,R/S逐渐变小.左右手反向导联并加做V2、V3R、V5R代替V1、V3、V5导联心电图示,PI由倒置转直立,PaVR转倒置,PV3R、5R转直立.分析以上心电图,具有下列特征:I、aVL导联各波倒置,胸前导联R波有自右向左递减现象,而将左右手导联互调并加做V2、V3R、V5R后心电图形基本为前面的"镜像位"心电图,符合右位心心电图特征,故诊断为右位心.
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