Di Chiara A, Plewka M, Fioretti P M
Coronary Care Unit, Cardiology Department, Azienda Ospedaliera S. Maria della Misericordia, Udine, Italy.
J Am Soc Echocardiogr. 1999 Dec;12(12):1117-21. doi: 10.1016/s0894-7317(99)70113-6.
We describe a singular case of a 75-year-old woman affected by an anterior acute myocardial infarction in the subset of a very recent orthopaedic surgery. She had had severe mitral regurgitation on coronary angiography. A thorough cardiac echocardiographic examination revealed the particular mechanism of mitral incompetence, consisting of a dynamic anterior mitral leaflet displacement caused by a sustained compensatory left ventricle hypercontractility and favored by postsurgical moderate anemia and mild hypertensive hypertrophy. The use of beta-blockers and the avoidance of pure vasodilators permitted complete reversal of such mechanisms during the clinical course.
我们描述了一例特殊病例，一名75岁女性在近期接受骨科手术后发生了前壁急性心肌梗死。冠状动脉造影显示她患有严重二尖瓣反流。全面的心脏超声心动图检查揭示了二尖瓣关闭不全的特殊机制，其由持续性代偿性左心室过度收缩导致二尖瓣前叶动态移位引起，且术后中度贫血和轻度高血压性肥厚也促使了这种情况的发生。在临床过程中，使用β受体阻滞剂并避免使用单纯血管扩张剂使这些机制完全逆转。
