Matangi M F, Norris R M, Hill D G
N Z Med J. 1983 Dec 14;96(745):1003-5.
Three cases of subacute cardiac rupture following acute myocardial infarction are described. All three patients experienced sudden collapse during convalescence and following cardiopulmonary resuscitation were in cardiogenic shock, the shock being due to haemopericardium causing cardiac tamponade. Two of the patients who had electrocardiographic monitoring at the time of their collapse showed nodal bradycardia and were apnoeic and unconscious with no recordable blood pressure (electromechanical dissociation). The diagnosis was confirmed in all three patients by echocardiography which showed pericardial fluid. The patients were referred for urgent cardiac surgery (infarctectomy and Teflon patching) without further investigation. All three patients survived the emergency operation, but two died soon after surgery. The third patient is alive and well five months after the operation.
本文描述了3例急性心肌梗死后亚急性心脏破裂的病例。所有3例患者在恢复期均突然出现病情恶化，心肺复苏后均处于心源性休克状态，休克是由于心包积血导致心脏压塞所致。其中2例患者在病情恶化时进行了心电图监测，显示结性心动过缓，呼吸暂停且昏迷，血压无法测得（电机械分离）。所有3例患者均通过超声心动图确诊，超声心动图显示有心包积液。患者未经进一步检查即被转诊进行紧急心脏手术（梗死切除术和聚四氟乙烯修补术）。所有3例患者均在急诊手术后存活，但2例在术后不久死亡。第3例患者术后5个月仍存活且情况良好。
