50例急性右室心肌梗死临床分析

Clinical Analysis in 50 Patients with Acute Right Ventricular Myocardial Infarction

目的:探讨50例急性右室心肌梗死(MI)患者的临床特点。方法:对50例确诊为急性右室MI包括合并下壁和(或)正后壁及前壁MI的患者临床资料进行回顾性分析。结果:单纯右室MI患者2例,合并下壁和(或)后壁患者34例,合并前壁患者14例,同时有下壁和(或)后壁+前壁患者2例。心力衰竭患者22例(44%),室性心律失常27例(54%),Ⅲ度房室传导阻滞(AVB)5例(10%),住院死亡5例(10%)。结论:临床上急性MI出现右心衰竭症状患者应该考虑存在右室MI;合并右室MI漏诊率高、诊疗相对困难、死亡率高;治疗上与其他MI存在一定差异,应区别对待,否则影响预后。

Objective： To explore the clinical characteristics in the patients with Acute Right Ventrieular Myocardial Infarction. Methods： 50 eases were diagnosed as acute right ventrieular myocardial infarction, combined with inferior, posterior and anterior wall myocardial infarction .Their clinical data were analyzed retrospeetively.Results： 2 eases were diagnosed as right ventrieular myocardial infarction, 34 eases were combined with inferior and posterior wall myocardial infarction, 14 cases were combined anterior wall infarction. 2 eases were combined with anterior, posterior and inferior wall myocardial infarction. 22 patients were suffered heart failure （44%）, 27 eases were incurred ventrieular arrhythrnias（54% ）, 5 eases occurred Ⅲ° atrioventrieular bloek（AVB） （ 10% ）, 5 eases died in hospital（ 10% ）. Conclusions： The morbidity of acute myocardial infarction in right ventrieular was lower than in left ventrieular. The diagnosis and treatment of the former were more diffieuh than the later. We should consider the existence of right ventrieular myocardial infarction when right heart failure symptoms happened. So Physicians should pay attention to the application of fluid replacement and nitroglycerin.