Rua Ramiro Barcelos 2350, Porto Alegre, RS, Brazil.
J Invasive Cardiol. 2022 May;34(5):E416-E417. doi: 10.25270/jic/21.00400.
This case illustrates a rare but catastrophic complication of acute myocardial infarction, ie, acute rupture of the left ventricular free wall. The majority of patients have hemodynamic impairment on arrival, and a high level of suspicion is needed. Point-of-care echocardiogram is valuable for prompt diagnosis. Management is very challenging and is based on fluid infusion, inotropic support, and pericardiocentesis. Emergency coronary artery bypass grafting and ventricular wall suture may be the only definitive treatment available, although in the majority of cases timely treatment is not possible.
本病例说明了急性心肌梗死一种罕见但灾难性的并发症，即左心室游离壁的急性破裂。大多数患者在到达时存在血流动力学障碍，因此需要高度怀疑。即时床旁超声心动图对快速诊断很有价值。治疗极具挑战性，基于输液、正性肌力支持和心包穿刺引流。紧急冠状动脉旁路移植术和心室壁缝合术可能是唯一可行的确定性治疗方法，尽管在大多数情况下，及时治疗是不可能的。
