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Zavajajoče EKG spremembe pri prsni bolečini: prikaz primera = Misleading ECG changes in acute chest pain: case report
Podlesnikar, Tomaž ; Gričar, Marko, 1964-
Bolniki z AKS imajo lahko povsem enake bolezenske simptome in znake. Pri obeh bolezenskih sindromih so navadno prisotne tudi spremembe v EKG. V pričujočem prispevku predstavljamo primer bolnice s PE, ...ki je tožila nad bolečinami v prsih in težkim dihanjem in pri kateri so bili prehodno v EKG prisotni negativni T valovi v odvodih V3-V6. Zlasti slednje je vodilo naše diferencialno diagnostično razmišljanje v smeri AKS. Po podatkih iz literature so namreč negativni T valovi v sklopu PE navadno omejeni na V1-V3/V4 in tudi po naših kliničnih izkušnjah se le redko razširijo na odvode stranske sten (V5-V6). Mnogo bolj pogosto srečamo tako jasno izražene in obsežne EKG spremembe v sklopu AKS, pri Wallensovem sindromu. Kadarkoli, po negativni koronarografiji smo postavili pravilno diagnozo in bolnico uspešno zdravili. Dejstvo, da lahko v sklopu PE nastanejo negativni T valovi v vseh prekordialnih odvodih, pomeni dodatno prekrivanje klinične slike z AKS, kar je potrebno imeti v mislih, ko imamo pred seboj bolnika z akutno nastalo prsno bolečino.
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