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心肌梗死的机械并发症。

Mechanical Complications of Myocardial Infarction.

机构信息

Pennsylvania Hospital of the University of Pennsylvania Health System, Philadelphia.

Pennsylvania Hospital of the University of Pennsylvania Health System, Philadelphia.

出版信息

Am J Med. 2022 Dec;135(12):1401-1409. doi: 10.1016/j.amjmed.2022.08.017. Epub 2022 Sep 6.

Abstract

Mechanical complications of myocardial infarction include rupture of a papillary muscle, ventricular septum, and free wall. Since the advent of acute coronary reperfusion, there has been a significant reduction in the incidence of these complications. One must have a high index of suspicion for a mechanical complication in any patient who develops cardiogenic shock in the days following a myocardial infarction. The most important diagnostic investigation in evaluation of these complications is echocardiography. Although there is a role for mechanical circulatory support, urgent surgical repair is required in most cases. We will review the predictors, clinical features, diagnostic, and management strategies in patients with these complications.

摘要

心肌梗死的机械并发症包括乳头肌、室间隔和游离壁破裂。自急性冠状动脉再灌注出现以来,这些并发症的发生率显著降低。对于心肌梗死后数天发生心源性休克的任何患者,都必须高度怀疑机械性并发症。在评估这些并发症时,最重要的诊断性检查是超声心动图。尽管机械循环支持有一定作用,但大多数情况下需要紧急手术修复。我们将回顾这些并发症患者的预测因素、临床特征、诊断和治疗策略。

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