Division of Cardiology, New York University Grossman School of Medicine, 550 First Avenue, New York, NY, 10016, USA.
Curr Cardiol Rep. 2024 May;26(5):393-404. doi: 10.1007/s11886-024-02042-5. Epub 2024 Mar 25.
Although rare, the development of mechanical complications following an acute myocardial infarction is associated with a high morbidity and mortality. Here, we review the clinical features, diagnostic strategy, and treatment options for each of the mechanical complications, with a focus on the role of echocardiography.
The growth of percutaneous structural interventions worldwide has given rise to new non-surgical options for management of mechanical complications. As such, select patients may benefit from a novel use of these established treatment methods. A thorough understanding of the two-dimensional, three-dimensional, color Doppler, and spectral Doppler findings for each mechanical complication is essential in recognizing major causes of hemodynamic decompensation after an acute myocardial infarction. Thereafter, echocardiography can aid in the selection and maintenance of mechanical circulatory support and potentially facilitate the use of a percutaneous intervention.
急性心肌梗死后机械并发症虽罕见,但发病率和死亡率均较高。本文主要探讨机械并发症的临床特征、诊断策略及治疗选择,并重点介绍超声心动图的作用。
全球经皮结构性介入治疗的发展为机械并发症的治疗提供了新的非手术选择。因此,部分患者可能受益于这些既定治疗方法的新应用。全面掌握二维、三维、彩色多普勒和频谱多普勒在每种机械并发症中的表现,对于识别急性心肌梗死后血流动力学恶化的主要原因至关重要。此后,超声心动图有助于选择和维持机械循环支持,并可能促进经皮介入的应用。