Li Tan, Kong Fan-Xin, Wang Jun-Li, Yang Jun, Ma Chun-Yan
Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, China.
J Clin Ultrasound. 2019 May;47(4):247-252. doi: 10.1002/jcu.22684. Epub 2019 Jan 4.
Right ventricular (RV) wall dissection following ventricular septal rupture related to inferior myocardial infarction (MI) is an extremely rare complication with a high mortality rate. We report the case of a 61-year-old man who was admitted to our hospital because of syncope and intermittent chest pain with a precordial murmur. Transthoracic echocardiography showed a rupture at the basal infero-posterior septum and RV free-wall dissection forming an echolucent cavity that extended beyond the septum and subsequently re-entered into RV chamber. The patient's overall cardiac and renal functions deteriorated and he died 24 days after the diagnosis. We present a literature review of the published cases of complex dissecting tracts through the septum and RV wall in ischemic context.
与下壁心肌梗死相关的室间隔破裂后右心室壁夹层是一种极其罕见的并发症，死亡率很高。我们报告一例61岁男性患者，因晕厥、间歇性胸痛伴心前区杂音入院。经胸超声心动图显示基底部下后壁间隔破裂，右心室游离壁夹层形成一个无回声腔，该腔延伸至间隔之外，随后重新进入右心室腔。患者的整体心脏和肾功能恶化，诊断后24天死亡。我们对已发表的缺血情况下穿过间隔和右心室壁的复杂夹层病例进行了文献综述。
