儿童心肌梗死及心电图酷似心肌梗死的超声心动图鉴别  

Differential Diagnosis of Myocarial Infarction from Diseases Whose ECG Resemble Myocardial Infarction in Children by Echocardiography

作　　者：魏亚娟[1] 赵晓兰[1] 刘保民[1] 

机构地区：[1]西安交通大学医学院第二附属医院超声研究室,西安市710004

出　　处：《中国超声医学杂志》2014年第1期34-37,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨儿童心肌梗死及心电图酷似心肌梗死者的超声心动图特征与病因鉴别。方法回顾性总结8例儿童急性心肌梗死及11例心电图酷似心肌梗死者的病因和超声心动图特征。经冠脉造影、尸检或术后病理证实者共5例。结果(1)儿童急性心肌梗死8例者:川崎病伴冠状动脉瘤5例,左冠状动脉异常起源于肺动脉、感染性心内膜炎、大动脉炎各1例。超声心动图显示左室壁节段性室壁运动障碍、左房左室扩大、左心功能不全及二尖瓣反流。(2)心电图酷似心肌梗死者11例:包括重症病毒性心肌炎4例;缩窄性心包炎、心脏枪击伤各1例;肥厚型心肌病3例;心脏横纹肌瘤2例。结论儿童心肌梗死发病原因显著不同于成人,超声心动图有助于儿童心肌梗死及心电图酷似心肌梗死者病因的鉴别诊断并指导治疗。Objective To explore the value of echocardiography in differential diagnosis of myocardial infarction from other diseases whose ECG resemble myocardial infarction in children. Methods Echocardiographic features and etiology of 8 children with acute myocardial infarction and 11 children with other diseases whose ECG resemble myo- cardial infarction were reviewed. Of them, 5 cases were confirmed by coronary angiography, autopsy or operation. Re- suits （1） In the 8 cases of children acute myocardial infarction, there were 5 cases of coronary artery aneurysms com- plicated by Kawasaki disease. The others were 1 case of left coronary artery originating from pulmonary artery, 1 case of infectious endocarditis and 1 case of aortoarteritis. Echocardiography showed segmental wall motion disorders of left ventricular, enlargement of left atrial and ventricular, left ventricular dysfunction and mitral regurgitation. （2） Disea- ses whose ECG resemble myocardial infarction included 4 cases of severe myocarditis, 1 case of constructive pericardi- tis, 1 case of gunshot wound of the heart, 3 cases of hypertrophic cardiomyopathy and 2 cases of cardiac rhabdomyo- ma. Conclusions The etiology of children myocardial infarction was different from that of the adults. Echocardio- graphy can be helpful in the differential diagnosis of myocardial infarction from diseases whose ECG resemble myocar- dial infarction in children.

关 键 词：儿童 心肌梗死 超声心动图 

分 类 号：R725.4[医药卫生—儿科] R445.1[医药卫生—临床医学]