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 Wysłany: Czw 0:05, 10 Mar 2011 Temat postu: Admission electrocardiogram in acute myocardial in |
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Admission electrocardiogram in acute myocardial infarction prognostic prediction of
'22 Electrocardiogram (EKG) in the diagnosis of acute myocardial infarction (AMI), the main basis, is also the primary means of judging the prognosis of AMI, Q-known EKG Phi, S-T elevation AMI can determine the extent, predictable prognosis, however, was alone in clinical practice imperfect. Although in recent years on the Q-T dispersion, heart rate variability was studied, because of equipment limitations,[link widoczny dla zalogowanych], the majority of primary hospital is not yet universal. From the 114 cases of AMI in the surface EKG in trying to find other valuable indicators to estimate the condition and prognosis. 1 Division of Clinical turn to fall from 1985 to 1993, AMI, 114 patients, consistent with WHO diagnostic criteria for diagnosis of 90 cases of male and 24 female down, aged 3s ~ 80 years, mean 57 8 years old soil. Q Phi AMI has accounted for 97.5, 3.5 non-Q wave AMI accounted for; a Q wave AMI, the inferior wall, 27, anterior total 3O, accounting for the high sidewall 7, accounting for 26 anteroseptal, posterior wall accounted for 0 .9, right ventricle, 4. The total mortality rate was 12.2. 2 2.1 methods methods and results,[link widoczny dla zalogowanych], without complications and death from the three groups at admission EKGt infarction, the corresponding lead S-T depression, acute right bundle branch block (RBBB) , PtfV, atrioventricular block (AVB) and other aspects of control. 2.2 Results 2.2.1 infarction right ventricular myocardial infarction rate was 4 (5 / 114), while the fatality rate of 60 (3 / 5), 4 / 5 associated with an inferior wall AMI, 1 / 5 associated with the anterior wall AMI, the cause of death was severe shock (see Table 1). Table 1 Relationship between infarction site and mortality in 2.2.2 corresponds to lead down a Q s-T transition in the corresponding occurrence of AMI lead s-T depression accounted for 35 (38/114), all (1O0Yo) complications, died was 32 (12/3 . Where s-T depression ≥ 1.5 ~ 6mm mortality of those 85.7 (12/14), depression levels were positively correlated with mortality. Table 2 corresponds to the lead s-T depression and complications, the relationship things pot died of acute myocardial infarction 2.2.3 RBBB. Occurred in this group was 3.5 (4 / 114), mortality was 25 (1 / 4), all patients were pump failure occurs. The longest case of RBBB died 5 days. 2.2.4AVB AVB occurred in this group accounted for 5.2 AMI (6./11),[link widoczny dla zalogowanych], 3 cases of I degree AVB, no death. 3 down for the l ° AVB, 2 died. 3 Discussion 3.1 The importance of right ventricular myocardial infarction (RVMI) RVMI the early diagnosis of multiple secondary to inferior wall AMI, the clinical to right ventricular failure as the main feature, but may also occur anterior wall AMI, cardiogenic shock associated with the prognosis poor. Although RVMI from the pathological,[link widoczny dla zalogowanych], clinical and EKG antemortem diagnosis of progressive access to Liu, the current clinical diagnosis was still not high, especially RVMI 10 of 20 occurred in the left anterior descending artery, associated with the anterior wall AMI, easily overlooked. The Group 1 reverse acute anterior infarction, the formal solution is still picking up after treatment of angina, heart failure, cardiogenic shock right ventricular dysfunction occurs gradually, and then measure right ventricular ECG, RV's S-T elevation 1. 5mm, review the eight hospital EKG, that s-T low-, S-Tv elevation, the final stage 1V pump failure and death. Therefore, to early detection RVMI, proposed: ① All AMI must be 18-lead EKG ② s-Tv elevation, s-Tv: depression should alert RVMI; ③ S-TaVF elevation,[link widoczny dla zalogowanych], S-Tv down t the S-Tv reduced by 1, avF elevation ≤ 0.5, with a diagnosis of RVMI value. 3.2AMI with RBBB car group 4 patients had RBBB, including a back wall before the AMI, with acute RBBB, 5 days in the hospital died of pump failure, the other 3 cases the possibility of pump failure, so AMI is coronary merger RBBB involved a serious basis. 3.3 corresponds to lead S-T depression generally considered inferior, the former with the wall AM1 good prognosis, the mortality is low, but its appearance corresponds to the level of lead S-T depression, especially when depression ≥ 1.5Ely], mortality is high, up to 85.5% in this group, reason, reflect both the infarcted electrophysiological t is the corresponding body ischemia in the performance area, while the corresponding s-T leads down the extent of infarct size can be considered, with a forecast value. (Received when you hear 1997-05-0 * 361 *
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