六例老年人右室心肌梗死临床与病理分析

Right ventricular myocardial infarction in aged patients: a clinical pathological study of six cases

目的探讨老年人右室心肌梗死（ＲＶＭＩ）临床表现和病理解剖的特点。方法分析５１例因急性心肌梗死而死亡经尸检的老年患者中６例合并ＲＶＭＩ的临床病理资料。结果ＲＶＭＩ发生率为１１．８％，右胸前导联心电图对早期诊断ＲＶＭＩ有价值。６例中４例伴发于大面积、多部位的左室梗死，且均见左室下壁梗死；冠状动脉病变多在左冠脉前降支及右冠脉。３例发生心脏破裂。结论老年人ＲＶＭＩ有不同于左室梗死的特点，临床上应高度重视。

Objective To study the clinical and pathological manifestations of right ventricular myocardial infarction (RVMI) in aged patients. Methods Six autopsied cases of RVMI of aged patients were studied. Results The incidence of RVMI in aged patients was 11 8%.Right precardial electrocardiogram was valuable in early diagnosis of RVMI. RVMI was frequently associated with left ventricular infarction of large area or multiple foci. Left inferior wall was mostly involved. Narrowing or occlusion of left anterior descending or right coronary artery was mainly responsible for RVMI. When RVMI occured in association with acute left ventricular myocardial infarction, prognosis was bad. Heart rupture occurred in three cases. Conclusions The features of RVMI were different from left ventricular infarction. So it should be paid attention to.