Pennsylvania Hospital of the University of Pennsylvania Health System, Philadelphia.
Pennsylvania Hospital of the University of Pennsylvania Health System, Philadelphia.
Am J Med. 2022 Dec;135(12):1401-1409. doi: 10.1016/j.amjmed.2022.08.017. Epub 2022 Sep 6.
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.
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。
