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心肌梗死后右心室衰竭的管理

Management of Post-Myocardial Infarction Right Ventricular Failure.

作者信息

Haloot Justin, Mahmoud Mohamed, Prasad Anand, Anderson Allen S, Aslam M Imran

机构信息

Division of Cardiology, Department of Medicine, University of Texas Health San Antonio, San Antonio, Texas.

出版信息

J Soc Cardiovasc Angiogr Interv. 2022 Nov 26;2(1):100526. doi: 10.1016/j.jscai.2022.100526. eCollection 2023 Jan-Feb.

Abstract

Right ventricular failure (RVF) due to an acute myocardial infarction (MI) has been associated with high morbidity and mortality. Initial treatment is guided by early recognition and prompt revascularization. Current management of post-MI RVF is built upon expert consensus and is also informed by RVF from other etiologies, including massive pulmonary embolism, left ventricular assist device-associated right ventricular dysfunction, postcardiotomy shock, etc.; this speaks to the limited data available on the specific management of RVF in acute MI. The goal of this review is to discuss the current literature on the pathophysiology, general management considerations, interventional management, hemodynamic monitoring, medical management, and mechanical circulatory support of MI-induced RVF.

摘要

急性心肌梗死(MI)所致的右心室衰竭(RVF)与高发病率和死亡率相关。初始治疗以早期识别和及时血运重建为指导。心肌梗死后右心室衰竭的当前管理基于专家共识,同时也参考了其他病因导致的右心室衰竭,包括大面积肺栓塞、左心室辅助装置相关的右心室功能障碍、心脏术后休克等;这表明关于急性心肌梗死中右心室衰竭的具体管理的可用数据有限。本综述的目的是讨论当前关于心肌梗死所致右心室衰竭的病理生理学、一般管理考虑因素、介入管理、血流动力学监测、药物治疗和机械循环支持的文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcd0/11308243/124ef90f806b/fx1.jpg

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