邱静,苏冠华.致心律失常性右室心肌病2例并文献复习[J].内科急危重症杂志,2016,22(6):
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| DOI： |
| 中文关键词: 致心律失常性右室心肌病 室性心动过速 Epsilon波 电风暴 心脏移植 |
| 英文关键词:Arrhythmogenic right ventricular cardiomyopathy ventricular arrhythmias Epsilon waves electrical storm heart transplantation |
| 基金项目:湖北省生物靶向治疗研究重点实验室(编号：02.03.2014-10)；中央高校基本科研业务费专项资金资助华中科技大学自主创新研究(编号：2014QN057) |
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| 中文摘要: |
| 目的：探讨致心律失常性右室心肌病的临床特点、心电图特征、诊断及治疗。方法：对2例致心律失常性右室心肌病患者的临床资料进行回顾性分析,并进行文献复习。结果：患者1,46岁,男性,因“反复胸闷心慌1月,晕厥1次”入院,曾有室速发作,未发作时心电图可见Epsilon波,给予抗心律失常、营养心肌、改善循环等对症支持治疗,症状好转出院；患者2,37岁,女性,因“间断心悸十年,再发加重十天”入院,反复发生室速电风暴,静息心电图可见Epsilon波,给予抗心律失常、电复律治疗稳定后行心脏移植术,患者痊愈出院。结论：致心律失常性右室心肌病可有较特异的心电图表现如Epsilon波,多合并室速等恶性心律失常,预后较差,诊断明确后尽早行抗心律失常或埋藏式心脏复律除颤器植入治疗,终末期可选择心脏移植。 |
| 英文摘要: |
| Objective: To explore and evaluate clinical manifestation, electrocardiographic (ECG) features, diagnosis and treatment of arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods: Clinical data wereSretrospectivelySanalyzedSin two cases with arrhythmogenic right ventricular cardiomyopathy, and related literatures were reviewed. Results: Case 1, male, 46-year-old, the chief complaint of whom was chest distress and palpitation for one month, suffering from syncope once. The patient had suffered from ventricular tachycardia (VT) attack, and rest ECG showed Epsilon wave. After anti-arrhythmia treatment and nutritional therapy of myocardium, his symptoms were improved markedly. Case 2, female, 37-year-old, the chief complaints of whom were intermittent palpitation for ten years, and exacerbation for ten days. The patient has been suffered from VT electrical storm, and rest ECG showed Epsilon wave, of whom was treated with anti-arrhythmia drugs, electrical cardioversion, and finally heart transplantation. Conclusions: Individuals with ARVCSalways have some specific ECGSfeatures such as Epsilon wave, and often complicated with malignant arrhythmias, and poor prognosis. After diagnosis of ARVC was confirmed, the patients should choose anti-arrhythmic or ICD therapy immediately. Heart transplantation may be helpful for end-stage patients. |
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