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心电图上病理性 Q 波常表示局部心肌丧失电兴奋传导功能,当心肌细胞坏死时,可呈现永久性 Q波,当心肌受可逆性缺血损害时,则可呈一过性 Q波。因此,当短暂急性心肌缺血时,心脏机械功能虽受到遏抑,若能采取积极治疗措施,则病理性 Q 波亦能消失,随后心脏功能亦可恢复正常。本文报告4例心肌严重缺血而出现一过性病理性 Q 波的病例,在缺血发作时作~(201)铊扫描观察心肌灌注,并作放射性核素心室造影观察室壁活动,从而证实在严重心肌缺血时,心脏电生理活动可同时受到干扰,但只要尚未达到坏死程度,则仍可恢复正常。例1为76岁女性,近期出现心绞痛加剧,经硝酸甘油不能缓解。在疼痛持续2小时后,心电图 V_2
Pathological Q-wave electrocardiogram often indicates that local myocardial loss of electrical excitation conduction function, when myocardial necrosis, can be a permanent Q wave, when the damage of the myocardium by reversible ischemia can be a transient Q wave. Therefore, when short-term acute myocardial ischemia, cardiac mechanical function was suppressed, if can take active treatment measures, the pathological Q waves also disappear, followed by heart function can be returned to normal. This article reports 4 cases of severe myocardial ischemia occurred a pathological Q-wave cases of a transient ischemic attack during ~ (201) thallium scan observed myocardial perfusion and radionuclide ventricular angiography to observe the activity of the wall to confirm In severe myocardial ischemia, cardiac electrophysiological activity may be disturbed at the same time, but as long as the degree of necrosis has not yet been reached, it may still return to normal. Example 1 is a 76-year-old woman with recent aggravating angina pectoris and no relief with nitroglycerin. After 2 hours of pain, ECG V_2