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目的 :总结心室壁心肌肿瘤的临床和心电图特点 ,意旨早期诊断。 方法 :对 1992年 12月～ 1999年 7月 5例经心脏影像检查发现并经手术和病理证实的心室壁心肌肿瘤患者的临床和心电图特点进行总结分析。 结果 :本组 5例经病理证实为心室壁心肌肿瘤 ,其中 ,左心室心肌海绵体瘤 ,脂肪瘤、浸润性脂肪瘤、左心室和双心室心肌纤维瘤各 1例。 5例均以室性心动过速 (VT)为首发临床表现 ,心室率在 16 0～ 2 0 0次 /分 ;心电图 (ECG)均有酷似心肌梗塞改变 ,包括异常 Q波 2例 ,ST段抬高 2例 ,T波深度倒置 5例 ,又均无明确的心肌梗塞史 ;而且 ,肿瘤部位与 ECG异常所在导联和 VT起源部位基本一致 ,其中 1例经心内电生理证实。 结论 :1对临床上以 VT为主要表现 ,并有 ECG酷似心肌梗塞改变又无明确心肌梗塞病史的患者 ,应高度疑诊为心室壁心肌肿瘤 ,并行影像学检查确诊。 2 ECG示酷似心肌梗塞所累及导联和 VT起源部位对心室壁心肌肿瘤有定位价值
Objective: To summarize the clinical and electrocardiographic features of ventricular wall myocardial tumors, aiming at early diagnosis. METHODS: The clinical and electrocardiographic characteristics of 5 patients with ventricular myocardial tumors identified from cardiac imaging examinations and confirmed by surgery and pathology from December 1992 to July 1999 were analyzed. Results: 5 cases of this group were pathologically confirmed as ventricular myocardial tumors, including left ventricular myocardial cavernous tumor, lipoma, infiltrating lipoma, left ventricular and biventricular myocardial fibroma in 1 case. In 5 patients, ventricular tachycardia (VT) was the first clinical manifestation, with a ventricular rate of 160 to 200 beats per minute; electrocardiogram (ECG) all resembled changes in myocardial infarction, including abnormal Q wave in 2 patients, ST segment In 2 patients with elevation, 5 cases of deep T wave inversion, there was no clear history of myocardial infarction. Moreover, the location of the tumor and the ECG abnormal lead and VT origin were basically the same, and 1 case was confirmed by intracardiac electrophysiology. Conclusion :1 For patients with VT as the main clinical manifestation, and ECG resembles the change of myocardial infarction without a clear history of myocardial infarction, it should be highly suspected as a ventricular wall myocardial tumor, and confirmed by imaging examination. 2 ECG is similar to myocardial infarction involving the origin of lead and VT origin location of ventricular myocardial tumor