Jedliński Ireneusz, Duszyńska Małgorzata, Bugajski Paweł, Kalawski Ryszard, Słomczyński Marek, Poprawski Kajetan
Oddział Kardiologiczny, Szpital im. J. Strusia, ul. Szkolna 8/12, 61-833 Poznań, Poland.
Kardiol Pol. 2009 Jun;67(6):687-9.
A case of acute severe mitral regurgitation with serious hemodynamic impairment in the setting of an inferior ST-elevation myocardial infarction is presented. Both transthoracic and transesophageal echocardiography demonstrated a posteriorly directed eccentric jet of severe mitral regurgitation with flail anterior mitral valve leaflet. The rupture of the postero-medial papillary muscle attached via chords to the anterior mitral valve leaflet was found. The direction and eccentricity of the mitral regurgitant jet on transthorasic and transesophageal echocardiography helped to point the leaflet involved, but not necessarily the coexisting papillary muscle pathology.
本文报告1例下壁ST段抬高型心肌梗死合并急性严重二尖瓣反流且伴有严重血流动力学损害的病例。经胸超声心动图和经食管超声心动图均显示二尖瓣前叶连枷样改变，伴有严重二尖瓣反流的偏心性反流束指向后方。发现后内侧乳头肌通过腱索附着于二尖瓣前叶处发生破裂。经胸和经食管超声心动图上二尖瓣反流束的方向和偏心性有助于确定受累的瓣叶，但不一定能明确并存的乳头肌病变情况。
