Widimský P, Gregor P, Cervenka V, Vísek V
Cor Vasa. 1984;26(1):27-31.
Five patients in cardiogenic shock due to acute myocardial infarction were examined by two-dimensional echocardiography. In one patient, cardiogenic shock developed only after rupture of the interventricular septum, four subjects had "primary" cardiogenic shock. In these four persons there were found extensive disturbances of left ventricular wall motion (the mean extent of the akinetic or dyskinetic zone amounted to 41% of the left ventricle (LV). However, equally extensive (and even larger) disturbances of LV kinetics were found in another 11 patients with acute MI, in whom there did not develop cardiogenic shock. The basic difference between the two groups consisted in the fact that in patients in cardiogenic shock the remaining part of the left ventricle exhibited severe hypokinesis, whereas in other infarcts it was normokinetic or hyperkinetic. Autopsy findings in all patients revealed severe diffuse involvement of all coronary arteries. In the discussion, it is pointed out that the above-mentioned phenomenon (hypokinesis of the "intact" part of the left ventricle) may be both one of the causes of shock as well as merely its consequence.
对5例因急性心肌梗死导致心源性休克的患者进行了二维超声心动图检查。其中1例患者仅在室间隔破裂后才发生心源性休克，另外4例患者发生“原发性”心源性休克。在这4例患者中，发现左心室壁运动广泛紊乱（运动减弱或运动障碍区域的平均范围达左心室（LV）的41%）。然而，在另外11例急性心肌梗死患者中也发现了同样广泛（甚至更大范围）的左心室动力学紊乱，这些患者并未发生心源性休克。两组之间的基本差异在于，心源性休克患者的左心室其余部分表现为严重运动减弱，而在其他梗死患者中，左心室运动正常或运动增强。所有患者的尸检结果均显示所有冠状动脉均有严重弥漫性受累。在讨论中指出，上述现象（左心室“完整”部分运动减弱）可能既是休克的原因之一，也仅仅是休克的后果。
