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急性前壁并右室心肌梗死较少见。现对急性前壁心肌梗死伴右胸导联(V3R、V4R)心电图ST抬高分析讨论如下。患者男,52岁。因“突发胸痛伴大汗2h”入院。查体:血压:105/75mmHg,心率:64bpm,大汗淋漓,颈静脉无怒张,心肺听诊未见异常。心电图(图1):窦性心律(58bpm)。QRS波形态:V1导联呈qrs、V2呈qr型。ST段:V1～V4、V3R、V4R、aVR、aVL导联抬高0.1～0.6mV,抬高幅度V2导联最明显(0.6mV),V2>V1>V3R>V4R;Ⅱ、Ⅲ、aVF、V7～V9导联ST段压低0.1～0.2mV。提示急性前壁、右室心肌梗死。急查心肌酶:CK1945U/L(参考
Acute anterior wall and right ventricular myocardial infarction is rare. Now the right anterior myocardial infarction with right chest lead (V3R, V4R) ECG ST elevation analysis is discussed below. Male patient, 52 years old. Because of “sudden chest pain with sweating 2h ” admission. Physical examination: blood pressure: 105 / 75mmHg, heart rate: 64bpm, sweating, no jugular vein engorgement, cardiopulmonary auscultation no abnormalities. Electrocardiogram (Figure 1): Sinus rhythm (58bpm). QRS wave morphology: V1 lead was qrs, V2 was qr type. In the ST segment, the lead of V1 ~ V4, V3R, V4R, aVR and aVL were elevated by 0.1 ~ 0.6mV, the most significant increase of the lead of V2 was 0.6mV, V2> V1> V3R> V7 ~ V9 lead ST segment depression 0.1 ~ 0.2mV. Tip acute anterior wall, right ventricular myocardial infarction. Urgent search of myocardial enzymes: CK1945U / L (Reference