伴继发性Lambda波的血管痉挛性心绞痛致意识丧失1例

引子

严重的冠脉痉挛除了引起房室传导阻滞等缓慢性心律失常以外，还可以表现为巨R波综合征、lambda 波，发生恶性心律失常的几率很高。

lambda 波伴快速心室率需要与巨R波综合征及室性心动过速相鉴别。

lambda 波出现的患者有条件者可完善相关的基因检查以明确是否为原发性离子通道病。

对于该患者lambda 波出现，除了药物治疗以外，是否需要植入ICD尚难确定。

以下为正文

lambda波国外研究

1.RieraA R P, Ferreira C, Schapachnik E, et al. Brugada syndrome withatypical ECG:downsloping ST-segment elevation in inferior leads[J].Journal of Electrocardiology, 2004, 37（2）∶101-104.2.Gussak I, Bjerregaard P, Kostis J. Electrocardiographic "Lambda" waveand primary idiopathic cardiac asystole:a new clinical syndrome?[J].Journal of Electrocardiology, 2004, 37（2）∶105-107.3.Potet F, Mabo P, Le Coq G, et al. Novel Brugada SCN5A mutationleading to ST segment elevation in the inferior or the right precordialleads[J]. Journal of Cardiovascular Electrophysiology, 2003, 14（2）∶200-203.4.Piotr Kukla, Marek Jastrz?bski, Jerzy Sacha, Leszek Bryniarski.Lambda-like ST segment elevation in acute myocardialinfarction – a new risk marker for ventricular fibrillation?Three case reports.Kardiol Pol,2008; 66: 873-8775.Maury P, Moreau A, Hidden-Lucet F, et al. Novel SCN5A mutations intwo families with "Brugada-like" ST elevation in the inferior leads andconduction disturbances [ J ] . Journal of Interventional CardiacElectrophysiology, 2013, 37（2）∶131-140.

作者丨东坡非坡

整理丨王德福

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