Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Клиническая задача: дифференциальная диагностика заболеваний, сопровождающихся подъемом сегмента ST
________________________________________________
Yalymov A.A., Shehyan G.G., Schikota A.M., Timofeeva N.Yu. Clinical problem: differential diagnosis of diseases accompanied by ST segment elevation. Handbook for Practitioners Doctors. 2017; 4: 36–38.
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Ключевые слова: синдром Бругада, блокада правой ножки пучка Гиса, элевация сегмента ST, желудочковая тахикардия, фибрилляция желудочков, синкопальные состояния, обморок, внезапная сердечная смерть.
________________________________________________
Electrocardiography (ECG) allows to diagnose hypertrophies of different parts of the heart, detect blockades and arrhythmias of the heart, determine the signs of ischemic damage to the myocardium, and indirectly judge extracardiac diseases, electrolyte disorders, the effects of different medications. Some electrocardiographic signs in combination with the characteristic clinical manifestations are combined into clinical and electrocardiographic syndromes. The most well-known clinical-electrocardiographic syndromes, such as CLC syndrome, Brugada syndrome, Chatterjee, Frederic, Morgagni–Adams–Stokes, etc. Despite all the variety of methods of functional diagnostics used in the practice of cardiologist, ECG holds its strong position as the "gold standard" for diagnosing cardiac arrhythmias and conduction. Currently, it is difficult to imagine a clinical medical institution without the possibility of ECG registration, but the possibility of expert interpretation of ECG is a rarity. The clinical problem is devoted to the diagnosis of Brugada syndrome. In this paper, we present a clinical example and additional medical examinations that allow us to diagnose Brugada's syndrome and determine the further tactics of examination and treatment. In the explanatory part, the task is given an illustrated description of the Brugada syndrome. The differential diagnosis of diseases accompanied by ST segment elevation on the ECG is carried out in the article.
Key words: Brugada syndrome, right bundle branch blockade, ST segment elevation, ventricular tachycardia, ventricular fibrillation, syncopal conditions, fainting.
2. Клиническая аритмология. Под ред. А.В.Ардашева. М.: Медпрактика-М, 2009. / Klinicheskaia aritmologiia. Pod red. A.V.Ardasheva. M.: Medpraktika-M, 2009. [in Russian]
3. Лиманкина И.Н. К вопросу о церебро-кардиальном синдроме у психически больных. Актуальные вопросы клинической и социальной психиатрии. Изд. СЗПД, 1999; с. 352–9. / Limankina I.N. K voprosu o tserebro-kardial'nom sindrome u psikhicheski bol'nykh. Aktual'nye voprosy klinicheskoi i sotsial'noi psikhiatrii. Izd. SZPD, 1999; s. 352–9. [in Russian]
4. Ялымов А.А., Шехян Г.Г., Щикота А.М. Руководство по электрокардиографии. Под ред. В.С.Задионченко. Saarbrucken, Germany: LAP LAMBERT Academic Publishing GmbH&Co. KG, 2011. / Ialymov A.A., Shekhian G.G., Shchikota A.M. Rukovodstvo po elektrokardiografii. Pod red. V.S.Zadionchenko. Saarbrucken, Germany: LAP LAMBERT Academic Publishing GmbH&Co. KG, 2011. [in Russian]
5. Antzelevitch C, Brugada P, Brugada J et al. Brugada syndrome: 1992-2002: a historical perspective. J Am Coll Cardiol 2003; 41: 1665–71.
6. Atarashi H, Ogawa S, Harumi K et al. Characteristics of patients with right bundle branch block and ST-segment elevation in right precordial leads. Am J Cardiol 1996; 78: 581–3.
7. Brugada R, Brugada J, Antzelevitch C et al. Sodium channel blockers identify risk for sudden death in patients with ST-segment elevation and right bundle branch block but structurally normal hearts. Circulation 2000; 101: 510–15.
________________________________________________
1. Dzhanashiia P.Kh., Kruglov V.A., Nazarenko V.A., Nikolenko S.A. Kardiomiopatii i miokardity. M.: Rossiiskii gosudarstvennyi meditsinskii universitet, 2000; s. 66–9. [in Russian]
2. Klinicheskaia aritmologiia. Pod red. A.V.Ardasheva. M.: Medpraktika-M, 2009. [in Russian]
3. Limankina I.N. K voprosu o tserebro-kardial'nom sindrome u psikhicheski bol'nykh. Aktual'nye voprosy klinicheskoi i sotsial'noi psikhiatrii. Izd. SZPD, 1999; s. 352–9. [in Russian]
4. Ialymov A.A., Shekhian G.G., Shchikota A.M. Rukovodstvo po elektrokardiografii. Pod red. V.S.Zadionchenko. Saarbrucken, Germany: LAP LAMBERT Academic Publishing GmbH&Co. KG, 2011. [in Russian]
5. Antzelevitch C, Brugada P, Brugada J et al. Brugada syndrome: 1992-2002: a historical perspective. J Am Coll Cardiol 2003; 41: 1665–71.
6. Atarashi H, Ogawa S, Harumi K et al. Characteristics of patients with right bundle branch block and ST-segment elevation in right precordial leads. Am J Cardiol 1996; 78: 581–3.
7. Brugada R, Brugada J, Antzelevitch C et al. Sodium channel blockers identify risk for sudden death in patients with ST-segment elevation and right bundle branch block but structurally normal hearts. Circulation 2000; 101: 510–15.
ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И.Евдокимова» Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1
*ayalymov@gmail.com
________________________________________________
A.A.Yalymov*, G.G.Shehyan, A.M.Schikota, N.Yu.Timofeeva
A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1
*ayalymov@gmail.com