Rosato G, Santomauro M, Stanco G, Petillo F, Sauro R, Chiariello M, Spampinato N, Rotiroti D
Department of Cardiology, Civil Hospital, Avellino, Italy.
Angiology. 1996 Feb;47(2):189-96. doi: 10.1177/000331979604700211.
The authors have focused this study on the emergence of subacute ventricular free wall rupture in a seventy-six-year-old patient admitted to hospital for inferior acute myocardial infarction. After six days he showed clinical signs of bradycardia and hypotension evolving to electromechanical dissociation. Given an adequate pharmacologic therapy, the patient was submitted to echocardiography, which was believed to be consistent with myocardial rupture, showing a moderate to large pericardial effusion. Pericardiocentesis of 150 mL of bloody fluid resulted in a further improvement in his hemodynamics. The patient underwent cardiac surgery with repair of the myocardial rupture through a large diaphragmatic infarction by a Dacron polyester fiber graft and pacemaker placement. In conclusion the authors confirm the relevant role of clinical data such as persistent chest pain and hemodynamic instability and the value of echocardiography in identifying subacute myocardial free wall rupture after an episode of acute myocardial infarction.
作者将这项研究聚焦于一名76岁因下壁急性心肌梗死入院的患者出现亚急性心室游离壁破裂的情况。六天后，他出现了心动过缓和低血压的临床症状，进而发展为电机械分离。在给予适当的药物治疗后，对该患者进行了超声心动图检查，结果被认为与心肌破裂相符，显示有中度至大量心包积液。抽出150毫升血性液体的心包穿刺术使他的血流动力学状况进一步改善。该患者接受了心脏手术，通过用涤纶聚酯纤维移植物修复大面积膈肌梗死所致的心肌破裂并植入起搏器。总之，作者证实了持续性胸痛和血流动力学不稳定等临床数据的相关作用，以及超声心动图在识别急性心肌梗死后亚急性心肌游离壁破裂方面的价值。
