Ischemické a neischemické příčiny elevace ST segmentu u pacientů s bolestí na hrudi: Systematický přehled literatury

Elektrokardiogram zůstává nejdůležitějším nástrojem v diagnóze infarktu myokardu s elevací ST segmentu. Je okamžitě k dispozici, je snadné jej opakovat a ekonomicky je velice výhodný. Pro trénovaného odborníka je rovněž vysoce citlivý a specifický. Časná diagnóza a následná léčba infarktu myokardu s elevací ST segmentu závisí na rychlém provedení a správné interpretaci EKG. Mimo akutního infarktu myokardu existuje u pacienta s probíhající bolestí na hrudi mnoho dalších příčin elevace ST segmentu. Lékař musí mít tyto diferenciální diagnózy na zřeteli a musí být schopen rychle potvrdit nebo vyvrátit alternativní příčiny elevace ST segmentu. Cílem tohoto článku je přezkoumání nálezů na EKG u akutního infarktu myokardu v porovnání s ostatními alternativními diagnózami, u kterých může docházet k elevaci ST segmentu. Tato diskuse je ukončena třemi kazuistickými příklady atypických příčin elevace ST segmentu u pacienta s bolestí na hrudi.

Klíčová slova:
elektrokardiogram – elevace ST segmentu – infarkt myokardu – diferenciální diagnóza

Autoři: M. Levine; Y. Kanei; M. Rachko; P. Schweitzer
Působiště autorů: Beth Israel Medical Center, New York, NY, USA
Vyšlo v časopise: Vnitř Lék 2012; 58(7 a 8): 54-59
Kategorie: 80. narozeniny prof. MUDr. Miroslava Mydlíka, DrSc.

Souhrn

Klíčová slova:
elektrokardiogram – elevace ST segmentu – infarkt myokardu – diferenciální diagnóza

Zdroje

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