Alexánderson E, Verdejo J, López J, Cárdenas M
Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Arch Inst Cardiol Mex. 1992 Mar-Apr;62(2):133-7.
Ventricular septal rupture in patients with acute myocardial infarction is not a common complication. It was found in 20 patients of 4298 admitted to the coronary care unit of the Instituto Nacional de Cardiología Ignacio Chávez from January 1980 to March 1991. The diagnosis was made by right heart catheterization if 85%, by echocardiography in 35% and by postmortem study in 15% of the patients. Mortality was 70%. In all patients the functional class worsened after the rupture, from class I to III or IV. There were not significant differences in mortality in relation to risk factors, or hemodynamic findings. Mortality was higher in older patients, females and patients with anterior myocardial infarction. Angiographic studies did not increase mortality and are necessary to establish an early surgical treatment.
急性心肌梗死患者发生室间隔破裂并非常见并发症。1980年1月至1991年3月期间,在墨西哥国立心脏病学研究所伊格纳西奥·查韦斯冠心病监护病房收治的4298例患者中,有20例发生了室间隔破裂。85%的患者通过右心导管检查确诊,35%通过超声心动图确诊,15%通过尸检确诊。死亡率为70%。所有患者在破裂后功能分级均恶化,从I级变为III级或IV级。在危险因素或血流动力学结果方面,死亡率没有显著差异。老年患者、女性患者和前壁心肌梗死患者的死亡率更高。血管造影研究不会增加死亡率,对于确定早期手术治疗是必要的。