Khatoon Salma, Goyfman Michael, Nabatian Sepideh, Henry Sonia, Bart Steinberg
Internal Medicine, Long Island Jewish Forest Hills Hospital, New York, USA.
Cardiology, Long Island Jewish Forest Hills Hospital, New York, USA.
Cureus. 2018 Dec 31;10(12):e3805. doi: 10.7759/cureus.3805.
Myocardial infarction (MI) is associated with complications in spite of appropriate management. The incidence of mechanical complications declined over time secondary to reperfusion therapies, improved control of blood pressure, the use of beta blockers and angiotensin-converting enzyme inhibitors, and aspirin. A high degree of suspicion is required, especially in elderly patients with complications post-PCI (percutaneous coronary intervention). Herein, we present a case of elderly male diagnosed with an inferior wall MI who had a PCI. He was found to have a post-infarction ventricular septal rupture (VSR) and basal inferior wall aneurysm that progressed over three weeks to a myocardial free wall rupture with hemopericardium. This case emphasizes the need for close monitoring of complications.
尽管进行了适当的治疗，心肌梗死（MI）仍会引发并发症。由于再灌注治疗、血压控制的改善、β受体阻滞剂和血管紧张素转换酶抑制剂的使用以及阿司匹林的应用，机械并发症的发生率随时间有所下降。高度怀疑是必要的，尤其是对于PCI（经皮冠状动脉介入治疗）术后出现并发症的老年患者。在此，我们报告一例诊断为下壁心肌梗死并接受PCI治疗的老年男性病例。他被发现患有心肌梗死后室间隔破裂（VSR）和基底后壁室壁瘤，在三周内进展为心肌游离壁破裂并伴有心包积血。该病例强调了密切监测并发症的必要性。
