Lomuscio A, Valenti D, Preti R, Longoni A, Benaglia D, Vergani D
Ospedale San Paolo, Milano Divisione di Cardiologia.
Minerva Med. 1987 Sep 30;78(18):1371-4.
Right ventricular infarction in inferior left ventricular infarction is very common. We have examined, by means of equilibrium gated radionuclide angiography, the relationship existing between right ventricular infarction and atrioventricular block. Seventy-two patients with inferior wall myocardial infarction were studied. Thirty-nine of them had ventriculographic evidence of right ventricular infarction. Fifteen of them (38%) had a-v block in the acute phase. Only 3 patients without right ventricular involvement (9%) had a-v block. The occurrence of a-v block is usually explained by the fact that the blood supply to the a-v node depends on the right coronary artery. In the patients with right ventricular involvement, the incidence of a-v block is high just because occlusion of the right coronary artery is proximal to the branch to the a-v node. However, the presence of collateral blood supply to the a-v node makes the occurrence of a-v node not so high as expected.
左心室下壁梗死合并右心室梗死非常常见。我们通过平衡门控放射性核素血管造影术研究了右心室梗死与房室传导阻滞之间的关系。对72例下壁心肌梗死患者进行了研究。其中39例有右心室梗死的心室造影证据。其中15例(38%)在急性期出现房室传导阻滞。只有3例无右心室受累的患者(9%)出现房室传导阻滞。房室传导阻滞的发生通常是由于房室结的血液供应依赖于右冠状动脉。在有右心室受累的患者中,房室传导阻滞的发生率很高,仅仅是因为右冠状动脉闭塞发生在其分支至房室结的近端。然而,房室结侧支血供的存在使得房室传导阻滞的发生率不像预期的那么高。