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目的分析磁共振定位的左室侧壁或侧壁联合下壁(侧下壁)梗死患者的心电图改变及梗死相关冠脉(infarction related artery,IRA)。方法选择2009年3月～9月在我院经磁共振心肌延迟增强(magnetic resonace imaging-myocardial delay enhancement MRI-MDE)扫描确定为左室侧壁或侧下壁梗死患者共5例,分析患者的心电图及冠脉造影结果。结果5例患者中4例Q波梗死,1例非Q波梗死,Q波梗死中2例侧下壁梗死,2例侧壁梗死,心电图均表现为V1导联高R波,R/S≥1,R波时限≥40ms,V7～V9导联病理性Q波;5例患者中4例IRA为回旋支(LCX)近段,其中2例累及钝缘支(OM),1例在LCX发出OM后次全闭塞。结论心电图V1导联高R波,R/S≥1,R波时限≥40ms,V7～V9导联病理性Q波对应于左室侧壁或侧下壁梗死,IRA多数为LCX。
Objective To analyze the changes of electrocardiogram (ECG) and infarct related artery (IRA) in patients with infarction on the left ventricular wall or side wall combined with the inferior wall (side wall) under magnetic resonance imaging. Methods A total of 5 patients with left ventricular wall or inferior wall infarction were selected from March 2009 to September 2009 in our hospital by magnetic resonance imaging-myocardial delay enhancement MRI-MDE. ECG and coronary angiography results. Results Among the 5 patients, Q wave infarction was found in 4 cases, non-Q wave infarction in 1 case, inferior wall infarction in 2 cases and lateral wall infarction in Q wave. ECG showed high R wave in V1 lead, R / S≥ 1, the R wave time≥40ms, the pathological Q waves of V7 ~ V9 lead; 4 of the 5 patients were in the proximal segment of LCX, of which 2 involved the obturator mesentery (OM) OM after the total occlusion. Conclusions The lead of ECG V1 has high R wave, R / S≥1 and the duration of R wave≥40ms. The pathological Q wave of V7 ~ V9 leads to left ventricular wall or inferior wall infarction, and the majority of IRA is LCX.