Yang X S, Sun J P, Huang D X
Jpn Heart J. 1985 Nov;26(6):935-41. doi: 10.1536/ihj.26.935.
Clinical and pathological findings in 15 autopsy cases, 13 males and 2 females, confirming cardiac free wall rupture after AMI were reported. The incidence is 30.6% of all autopsy cases of AMI in Chinese PLA General Hospital from 1958 to 1979. The ages ranged from 46 to 79 years, 10 being above 60 years. For 73.3% it was the first AMI and 66.7% of the patients had a history of hypertension. Thirteen of the 15 patients died within 5 days after the onset of AMI and another 2 within 7 days. When the cardiac rupture occurred, the ECG generally showed bradycardia, AV-junctional rhythm, III degrees AV block or isorhythmic ventricular rhythm and cardiac arrest. Both the gross and microscopic AMI were examined in 13 cases. All of them had a septal infarct, but only 2 had an ECG diagnosis. Of the 6 patients with inferior MI on ECG, 5 had right and left coronary lesions worse than grade III. The effective prevention of cardiac rupture consists of early diagnosis, control of chest pain and vomiting, prevention or treatment of hypertension or hypotension and 1 to 2 weeks of bed rest after the onset of AMI.
报告了15例尸检病例（13例男性，2例女性）的临床和病理结果，证实为急性心肌梗死后心脏游离壁破裂。在中国人民解放军总医院1958年至1979年所有急性心肌梗死尸检病例中，其发生率为30.6%。年龄范围为46至79岁，10例年龄在60岁以上。73.3%为首次急性心肌梗死，66.7%的患者有高血压病史。15例患者中有13例在急性心肌梗死发病后5天内死亡，另外2例在7天内死亡。心脏破裂发生时，心电图通常显示心动过缓、房室交界性心律、三度房室传导阻滞或等律性室性心律及心脏骤停。13例病例对急性心肌梗死进行了大体和显微镜检查。所有病例均有室间隔梗死，但仅有2例经心电图诊断。心电图显示下壁心肌梗死的6例患者中，5例左右冠状动脉病变程度超过Ⅲ级。急性心肌梗死后心脏破裂的有效预防措施包括早期诊断、控制胸痛和呕吐、预防或治疗高血压或低血压以及发病后1至2周卧床休息。
