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目的 观察左冠状动脉回旋支病变引起单纯后壁心肌梗死心电图改变。方法 对 12例经冠脉造影确诊单纯后壁急性心肌梗死病人 ,观察发病 6h后、12h、2 4h、7d、14d的心电图。结果 单纯后壁心肌梗死 6h内心电图特征 :①STⅤ 4,Ⅴ 5压低 0 5～ 1 0mm ;②Ⅴ2 、Ⅴ3 导联阳性U波增大 ,T/U比值减少。 12h后心电图特征 :①RⅤ 1,Ⅴ 2 渐增高 ,SⅤ 1,Ⅴ 2 渐减低 ,R/S比值≥ 1;②压低的ST段从发病至 2 4h回至基线 ;③TⅤ 1～Ⅴ 3 增高 ,U波渐低 ,T/U比值增大 ;④RⅤ 6渐低。结论 临床疑为急性心肌梗死时 ,不管有无ST T改变 ,凡右胸导联出现U波增高 ,T/U比值减小 ,应提示单纯后壁急性心肌梗死。
Objective To observe the electrocardiogram changes of left posterior myocardial infarction caused by left circumflex coronary artery disease. Methods 12 patients with acute posterior wall myocardial infarction diagnosed by coronary angiography were observed. The electrocardiogram was observed after 6h, 12h, 24h, 7d, 14d. Results The posterior myocardial infarction 6h ECG characteristics: ① STⅤ 4, Ⅴ 5 down 0 5 ~ 10mm; ② V2, Ⅴ lead positive U wave increased, T / U ratio decreased. After 12 hours, the electrocardiographic features were as follows: (1) R V 1 and V 2 gradually increased, S V 1 and V 2 decreased gradually, and the R / S ratio was 1; ② The depressed ST segment returned to baseline from onset to 24 hours; Waves gradually lower, T / U ratio increased; ④ R V 6 lower. Conclusions In patients with suspected acute myocardial infarction, regardless of the presence or absence of ST T changes, U wave increases and the T / U ratio decreases in the right thoracic leads. A simple posterior wall acute myocardial infarction should be indicated.