Mendes R G, Evora P R
Hospital do Coração de Ribeirão Preto/Fundação Waldemar Pessoa, SP-Brazil.
Arq Bras Cardiol. 1999 Mar;72(3):333-42. doi: 10.1590/s0066-782x1999000300007.
A patient with heart failure and acute atrial fibrillation received the final diagnosis of atrial infarction associated with ventricular infarction based on clinical findings of ischemia in association with atrial fibrillation and heart failure (mechanisms probably involved: contractile dysfunction and loss of atrial contribution). Although a transesophageal echocardiography, which could refine the diagnosis of anatomic abnormalities, was not performed, all evidence led to the diagnosis of atrial involvement. Electrocardiographic findings were consistent with Liu's major criterion 3. Therapy with digitalis, quinidine and angiotensin-converting enzyme inhibitors was chosen, as the patient had acute pulmonary edema. The use of beta-blockers and verapamil was res-tricted. No other complications, such as thrombo-embolism or atrial rupture, were noted.
一名患有心力衰竭和急性心房颤动的患者，根据与心房颤动和心力衰竭相关的缺血临床表现（可能涉及的机制：收缩功能障碍和心房贡献丧失），最终诊断为与心室梗死相关的心房梗死。尽管未进行可完善解剖异常诊断的经食管超声心动图检查，但所有证据均支持心房受累的诊断。心电图表现符合刘的主要标准3。由于患者有急性肺水肿，选择了洋地黄、奎尼丁和血管紧张素转换酶抑制剂治疗。β受体阻滞剂和维拉帕米的使用受到限制。未发现其他并发症，如血栓栓塞或心房破裂。
