Differential Diagnosis of Three Key Electrocardiographic Manifestations in Acute Non-ST-Segment Elevation Myocardial Infarction

LI Aitong.

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Differential Diagnosis of Three Key Electrocardiographic Manifestations in Acute Non-ST-Segment Elevation Myocardial Infarction

Clinical Research | 更新时间：2026-03-30

- Differential Diagnosis of Three Key Electrocardiographic Manifestations in Acute Non-ST-Segment Elevation Myocardial Infarction
- J Clin Electrocardiol Vol. 35, Issue 1, Pages: 52-56(2026)
- 作者机构：
  
  102218 北京，清华大学北京清华长庚医院心内科
- 作者简介：
- 基金信息：
- DOI：
  CLC： R541.7　R540.4+1
- Received：13 November 2025，
  
  Revised：2026-01-05，
  
  Accepted：12 January 2026，
  
  Published：28 February 2026
- 稿件说明：
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李艾桐. 3种急性非ST段抬高型心肌梗死危急心电现象鉴别[J]. 临床心电学杂志, 2026, 35(1): 52-56.

LI Aitong..Differential Diagnosis of Three Key Electrocardiographic Manifestations in Acute Non-ST-Segment Elevation Myocardial Infarction[J].J Clin Electrocardiol,2026,35(01):52-56.
李艾桐. 3种急性非ST段抬高型心肌梗死危急心电现象鉴别[J]. 临床心电学杂志, 2026, 35(1): 52-56. DOI：

LI Aitong..Differential Diagnosis of Three Key Electrocardiographic Manifestations in Acute Non-ST-Segment Elevation Myocardial Infarction[J].J Clin Electrocardiol,2026,35(01):52-56. DOI：

摘要

非ST段抬高急性冠状动脉综合征（Non-ST elevation acute coronary syndrome， NSTE-ACS），冠脉虽严重狭窄但常常存在富含血小板的血栓性不完全阻塞，患者常有一过性或短暂ST段压低或T波倒置、低平或“伪正常化”，也可无心电图改变。根据心肌损伤血清生物标志物将NSTE-ACS分为非ST段抬高型心肌梗死（Non-ST elevation myocardial infarction，NSTEMI）和不稳定心绞痛，两者发病机制和临床表现相似，其区别主要是缺血是否严重到导致心肌损伤。6+1现象及近几年推出的Aslanger征作为ST段抬高型心肌梗死等心电现象，多提示多支冠脉严重病变，目前尚缺少二者的比较，通过分析本文3例患者心电图及冠脉造影结果以期对临床医务人员提供帮助。

Abstract

Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) is characterized by significant coronary artery stenosis with incomplete thrombotic occlusion

often rich in platelets. Patients may exhibit transient or short-term ST-segment depression

T-wave inversion

flattening

or "pseudo-normalization

" or may show no electrocardiogram changes. Based on serum biomarkers of myocardial injury

NSTE-ACS is categorized into non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina. While both conditions share similar pathogenesis and clinical manifestations

the primary distinction lies in the severity of ischemia leading to myocardial injury. Recent studies have introduced the 6+1 phenomenon and the Aslanger sign as electrocardiographic equivalents of ST-segment elevation myocardial infarction

which frequently indicate severe multi-vessel coronary artery disease. However

comparative analyses between these phenomena are currently limited. This article presents three case studies to assist clinical practitioners.

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references

RICCI F , MARTINI C , SCORDO D M , et al . ECG patterns of occlusion myocardial infarction: a narrative review [J ] . Ann Emerg Med , 2025 , 85 ( 4 ): 330 - 340 . DOI: 10.1016/j.annemergmed.2024.11.019 http://dx.doi.org/10.1016/j.annemergmed.2024.11.019 .

中华医学会心血管病学分会 , 中华心血管病杂志编辑委员会 . 非ST段抬高型急性冠脉综合征诊断与治疗指南（2024） [J ] . 中华心血管病杂志 , 2024 , 52 ( 6 ): 615 - 646 . DOI: 10.3760/cma.j.cn112148-20240107-00014 http://dx.doi.org/10.3760/cma.j.cn112148-20240107-00014 .

MOUSTAFA A , ABI-SALEH B , EL-BABA M , et al . Anatomic distribution of culprit lesions in patients with non-ST-segment elevation myocardial infarction and normal ECG [J ] . Cardiovasc Diagn Ther , 2016 , 6 ( 1 ): 25 - 33 . DOI: 10.3978/j.issn.2223-3652.2015.10.05 http://dx.doi.org/10.3978/j.issn.2223-3652.2015.10.05 .

VOITH L , ÉDES I F , SKODA R , et al . Non-ST-elevation infarction, the stepchild of interventional myocardial salvage: experience of a single institute [J ] . Orv Hetil , 2023 , 164 ( 47 ): 1865 - 1870 . DOI： 10.1556/650.2023.32862 http://dx.doi.org/10.1556/650.2023.32862 .

DZIKOWICZ D J , CAREY M G . Secondary electrocardiographic stratification of NSTEMI to identify an acutely occluded culprit artery [J ] . Physiol Meas , 2023 , 44 ( 7 ). DOI: 10.1088/1361-6579/acddc8 http://dx.doi.org/10.1088/1361-6579/acddc8 .

LIU C W , YANG F , ZHANG J X , et al . Electrocardiographic patterns predict the presence of collateral circulation and in-hospital mortality in acute total left main occlusion [J ] . BMC Cardiovasc Disord , 2022 , 22 ( 1 ): 144 . DOI: 10.1186/s12872-022-02585-x http://dx.doi.org/10.1186/s12872-022-02585-x .

AGNESE M A V D , COPETTI A S , DE FERREIRA FILHO S F , et al . Aslanger's pattern with acute lesion in the left coronary system: A case report [J ] . J Electrocardiol , 2024 , 87 : 153807 . DOI: 10.1016/j.jelectrocard.2024.153807 http://dx.doi.org/10.1016/j.jelectrocard.2024.153807 .

晋军 , 詹中群 , 等 . 《急性冠脉综合征：心电图与临床》 [M ] . 郑州 : 河南科学技术出版社 , 2020 : 222 - 239 ．

李冰 , 孙涛 . 冠心病患者心电图QRS波时限和血清sST2水平与预后的关系及碎裂QRS波群形成的logistics分析 [J ] . 临床与病理杂志 , 2021 , 41 ( 8 ): 1782 - 1786 .

雷芾华 , 张峰 , 龚辉 . 不同类型老年心力衰竭患者QRS波时限及心率变异性与心功能相关性 [J ] . 中国老年学杂志 , 2023 , 43 ( 4 ): 785 - 788 . （收稿日期：2025-12-29）

BRADAI H , LAAJIMI S , MBAREK R , et al . Case Report: Case report: Aslanger's sign in electrocardiogram [J ] . F1000Res , 2024 , 13 : 1233 . DOI: 10.12688/f1000research.156313.2 http://dx.doi.org/10.12688/f1000research.156313.2 .

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