Tate D A, Lawton J J, DeGent G, Smith S C
Department of Medicine, University of North Carolina School of Medicine, Chapel Hill 27514, USA.
Cathet Cardiovasc Diagn. 1998 Aug;44(4):417-9. doi: 10.1002/(sici)1097-0304(199808)44:4<417::aid-ccd12>3.0.co;2-f.
Ventricular free-wall rupture is a well-known catastrophic complication of acute myocardial infarction. A significant number of patients present in a subacute fashion and can be successfully treated with surgery if diagnosed promptly. We present a case of subacute free-wall rupture that occurred after an undiagnosed myocardial infarction. The findings at pericardiocentesis were unusual in that the fluid was sanguinous but not frank hemopericardium. This patient represents the first known reported case to present without frank hemopericardium who survived and was successfully treated surgically. The absence of frank hemopericardium should not exclude the diagnosis of free-wall rupture.
心室游离壁破裂是急性心肌梗死一种众所周知的灾难性并发症。相当多的患者以亚急性形式出现，如果能及时诊断，手术治疗可获成功。我们报告一例未被诊断出的心肌梗死后发生的亚急性游离壁破裂病例。心包穿刺的结果不同寻常，抽出的液体为血性，但并非明显的血心包。该患者是首例已知报道的未出现明显血心包却存活且手术治疗成功的病例。无明显血心包不应排除游离壁破裂的诊断。
