Chida K, Ohkawa S, Nagashima K, Imai T, Kuboki K, Maeda S, Watanabe C
Division of Cardiology, Tokyo Metropolitan Geriatric Hospital, Japan.
Jpn Circ J. 1995 May;59(5):299-302. doi: 10.1253/jcj.59.299.
We report a 78-year-old woman with incomplete left atrial rupture following left atrial infarction associated with left ventricular myocardial infarction. An autopsy revealed a hemopericardium. A large hematoma was observed in the posterior wall of the left atrium and a few small tears were found on the same wall. Near its origin, the left circumflex artery was severely sclerotic and completely occluded by fresh thrombus. Histologic examination revealed that large intramural hematoma longitudinally dissected the inner third of the posterior wall of the left atrium, and transversely dissected through the necrotic tissue to the pericardial sac to result in rupture. Coagulation necrosis and intramyocardial hemorrhage were also observed throughout the entire left atrium and the postseptolateral wall of the left ventricle.
我们报告了一名78岁女性，其在发生与左心室心肌梗死相关的左心房梗死之后出现了不完全性左心房破裂。尸检发现心包积血。在左心房后壁观察到一个大血肿，且在同一壁上发现了一些小裂口。左旋支动脉在其起始部附近严重硬化，并被新鲜血栓完全阻塞。组织学检查显示，巨大的壁内血肿纵向剥离了左心房后壁内三分之一，横向穿过坏死组织至心包囊导致破裂。在整个左心房和左心室后外侧壁也观察到了凝固性坏死和心肌内出血。
