Meza-González Yilmar Alexander, Manzur-Barbur María Carolina, Ochoa-Díaz Andrés Felipe, Ariza-Ordoñez Nicolas, Vásquez-Rodríguez Juan Felipe, Rodríguez-González María Juliana
School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia.
School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia.
JACC Case Rep. 2025 Apr 2;30(7):103400. doi: 10.1016/j.jaccas.2025.103400.
Mechanical complications after acute myocardial infarction, including left ventricular free wall rupture, ventricular septal rupture, papillary muscle rupture, and pseudoaneurysm, although infrequent, are associated with significant morbidity and mortality. Despite the reduction in incidence because of early reperfusion therapies, their associated mortality rates remain disproportionately high. This disparity highlights the critical need for early detection and prompt intervention, which are key to improving patient outcomes in the postinfarction period. Timely restoration of coronary blood flow is essential for preventing complications, with reperfusion strategies, particularly percutaneous coronary intervention, serving as a cornerstone in minimizing ischemic injury. This review aims to provide an in-depth evaluation of the clinical, diagnostic, and therapeutic approaches to these mechanical complications with illustrative case studies to facilitate practical understanding of these conditions.
急性心肌梗死后的机械并发症，包括左心室游离壁破裂、室间隔破裂、乳头肌破裂和假性动脉瘤，虽然并不常见，但却与显著的发病率和死亡率相关。尽管由于早期再灌注治疗，其发病率有所降低，但其相关死亡率仍然过高。这种差异凸显了早期检测和及时干预的迫切需求，而这是改善心肌梗死后患者预后的关键。及时恢复冠状动脉血流对于预防并发症至关重要，再灌注策略，尤其是经皮冠状动脉介入治疗，是将缺血性损伤降至最低的基石。本综述旨在通过实例研究对这些机械并发症的临床、诊断和治疗方法进行深入评估，以促进对这些病症的实际理解。
