论文部分内容阅读
临床及心电图资料患者男,55岁,以阵发性胸骨后闷痛3个月入院。患者有高血压病史8年,间断服用复方降压片。查体:Bp20/13kPa(150/98mmHg),体型肥胖,房颤心律,心率约95次/分,心尖部和主动脉瓣第一听诊区均可闻及Ⅱ级收缩期杂音,心底部A_2>P_2,腹软,肝脾未及。血脂:胆同醇9.2mmol/L,甘油三酯1.9mmol/L。二维超声心动图示左室稍扩大,眼底见视网膜动脉硬化Ⅱ级。入院拟诊冠心病、高血压病。入院EKG记录见附图:上下二图为同次记录,上图为V_5导联,下图为aVR导联,各导联中均见P波消失,取而代之为小f波,R-R间距绝对不等,可判定为房颤心律。但需注意当R-R间距<0.64秒时,V_5导联T波直立,aVR导联T波深倒,当R-R间距>0.78秒时,V_5导联T波倒置或双向,aVR导联倒置变浅,心电图诊断房颤心律伴与心动周期有关的T波变化。
Clinical and electrocardiographic data Patient male, 55 years old, was admitted to the hospital with paroxysmal suprasternal tenderness and pain for 3 months. Patients with a history of hypertension for 8 years, intermittent taking compound antihypertensive tablets. Physical examination: Bp20 / 13kPa (150 / 98mmHg), body fat, atrial fibrillation heart rate, heart rate about 95 beats / min, apical and aortic valve auscultation area can be heard and Ⅱ systolic murmur, P_2, abdominal soft, liver and spleen not yet. Blood lipids: gall bladder alcohol 9.2mmol / L, triglyceride 1.9mmol / L. Two-dimensional echocardiography showed a slight enlargement of the left ventricle, retinal atherosclerosis Ⅱ grade. Admitted to be diagnosed coronary heart disease, hypertension. Admission EKG record See attached picture: The upper and lower two pictures for the same record, the picture shows the V_5 lead, the picture shows the aVR lead, P lead disappears in each lead, replaced by small f wave, RR spacing is absolutely unequal , Can be judged as atrial fibrillation heart rhythm. However, it should be noted that when the RR interval is less than 0.64 seconds, the T wave of the V_5 lead is upright and the T wave of the aVR lead is deep down. When the RR interval is> 0.78 seconds, the T lead of the V_5 lead is inverted or bidirectional, ECG Diagnosis of Atrial Fibrillation with Cardiac Tachycardia Related T-wave Changes.