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非ST段抬高型心肌梗死早期左心室游离壁破裂绝不可忽视。

Early left ventricular free-wall rupture in non-STEMI never to be neglected.

作者信息

Yeh Yen-Ting, Huang Chun-Yang

机构信息

Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

Cardiovascular Surgery Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

出版信息

Am J Emerg Med. 2016 Jan;34(1):113.e3-4. doi: 10.1016/j.ajem.2015.04.038. Epub 2015 Apr 24.

Abstract

As the most dramatic and fatal complication, left ventricular free-wall rupture (LVFWR) used to present in approximately 3% of patients with acute myocardial infarction. After the introduction of primary percutaneous coronary intervention, the incidence of LVFWR decreased but remained approximately 1.7%. Left ventricular free-wall rupture occurs in patients with transmural myocardial infarction, which is almost exclusively ST elevation myocardial infarction (STEMI). This condition carries a high mortality as a result of hemopericardium and cardiac tamponade. Left ventricular free-wall rupture rarely occurs in patients with non-ST-elevation myocardial infarction, but the risk of it cannot be ignored. This case describes early development LVFWR after non-ST-elevation myocardial infarction to evoke high vigilance of clinicians to this condition.

摘要

作为最严重且致命的并发症,左心室游离壁破裂(LVFWR)过去在约3%的急性心肌梗死患者中出现。在引入直接经皮冠状动脉介入治疗后,LVFWR的发生率有所下降,但仍约为1.7%。左心室游离壁破裂发生于透壁性心肌梗死患者,几乎均为ST段抬高型心肌梗死(STEMI)。由于心包积血和心脏压塞,这种情况死亡率很高。左心室游离壁破裂在非ST段抬高型心肌梗死患者中很少发生,但这种风险不可忽视。本病例描述了非ST段抬高型心肌梗死后LVFWR的早期发生,以引起临床医生对这种情况的高度警惕。

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