左主干病变acs心电图的识别.ppt

Tel: 010 Email:hc721@yahoo.cn * 多数情况下，心脏血流分布呈右优势型 左心室供血 左主干占60％～100％ * When we hear of sudden death from a heart attack, especially among the younger patients, this is usually caused by left main disease. And many times, without the classical symptoms of chest pains, or any indication at all that there is a blockage in the coronary artery. Teniente-Valente R, Lemarroy-Mendoza L, Mendoza-Gómez R, Solórzano-Zepeda FJ et al Left main coronary artery disease. Clinical features, morbility and mortality during cardiac catheterization and surgery results Original title: Enfermedad del tronco de la arteria coronaria izquierda. Características clínicas, morbilidad y mortalidad durante el cateterismo cardiaco y resultados de la cirugía Rev Mex Cardiol 2003; 14 (3): 86-93 ABSTRACT Objectives: To know the clinical characteristics before surgery, morbility and mortality during the cardiac catheterization and surgery results of the left main coronary artery (LMCI). Methods: Of the cardiac catheterization from January 1997 to July 2002 we selected the cases with obstructive disease of the LMCI with luminal narrowing of at least 50%. Results: In 1,946 patients who underwent coronary angiography there were 47 cases with LMCI (2.4%). Five files were not found and were excluded, leaving 42 cases, 10 women and 32 men, average age 62.6 years (44 to 78). 71.4% had elevation of serum cholesterol, 69% were smokers and 62.4% hypertension. 21 patients (50%) had stable angina, 15 patients (37.5%) had unstable angina and 6 patients (14.3%) had acute myocardial infarction. 17 patients (40.5%) had ECG evidence of remote myocardial infarction. Exercise testing for 25 patients was positive in 88% and in the 55% ST-T depression was 2 or more mm. The average of the left ventricular end-diastolic pressure was 11.1 mm Hg (0 to 40). The average ejection fraction was 60.4% (18 to 87). Left anterior descending was sick in 80.9%, circumflex in 71.4% and right coronary in 66.6%. In 19