以室性心动过速为首发临床表现的心脏肿瘤五例  

Ventricular tachycardia as the first clinical manifestation in five patients with heart tumor

作　　者：尤士杰[1] 杨跃进[1] 张奎俊[2] 华伟[2] 王方正[2] 陈纪林[1] 高润霖[1] 徐义枢[1] 陈在嘉[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院冠心病研究室,北京100037 [2]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院电生理研究室,北京100037

出　　处：《中华心律失常学杂志》2000年第4期266-269,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的　总结以室性心动过速为首发表现的心脏肿瘤的临床和心电图特点 ,以利及时诊断。　方法　对 1992年 12月～ 1999年 7月收治的 5例以室性心动过速为首发表现 ,后经影像学检查发现并经手术和病理证实的心脏肿瘤患者的临床和心电图特点进行分析。结果　本组 5例均以室性心动过速为首发临床表现 ,心室率 16 0～ 2 0 0次 / m in,其中 ,伴一过性头晕 3例 ,黑 2例。临床无其他症状和体征。既往均无心脏病史 ,而且肿瘤的所在实际部位与心电图所显示的室性期前收缩 ,乃至室性心动过速起源部位基本一致。其中 1例经心内电生理证实。　结论　对临床上以室性心动过速为主要表现的患者 ,应考虑到有心脏肿瘤的可能 ,应行影像学检查确诊。Objective To summarize the clinical and electrocardiographic features of heart tumor with ventricular tachycardia as the first clinical presentation. Methods The clinical and electrocardiographic features of ventricular tachycardia which was the first manifestation of ventricular intramural tumor were analyzed in 5 cases admitted from Dec.1992 to July.1999.The diagnosis was initially made by cardiac imaging,and finally was confirmed by surgery and pathology with the ventricular intramural tumor.Results All the 5 patients had paroxysmal ventricular tachycardia with a rate from 160 to 200 beats per minute.There was dizziness in three cases and near syncopy in two patients.However,they all had no history of apparent heart disease.The sites of origin of the ventricular tachycardia as predicted from the standard electrocardiography (ECG) were in agreement with the true location of the intracardial tumor,and confirmed by intracardiac electrophysiologic study in one patient. Conclusions For the patients with ventricular tachycardia as first clinical manifestation with no history of heart disease,ventricular intramural tumor may be a possible etiology.Cardiac imaging studies are needed.The origin of the ventricular tachycardia as predicted on standard ECG often coincides with the location of the ventricular intramural tumor.

关 键 词：室性心动过速 心脏肿瘤 心电图 

分 类 号：R732.1[医药卫生—肿瘤]