急性右心室梗塞13例报告

ANALYSIS OF 13 CASES WITH ACUTE RIGHT VENTRICULAR MYOCARDIAL IUFARCTION

报告13例急性右心室梗塞合并左室下壁梗塞.心电图显V_3R～V_6导联中一个或更多导联的ST段抬高均大于1mm;血流动力学检查发现右房压>13.3kPa,右室舒张未压升高,均呈平方根样右室压力曲线.急性心肌梗塞有右心衰表现和/或休克者,高度提示存在右心室梗塞,应结合心电图和血流动力学检查予以证实或排除.治疗原则是适量补液,有休克者加用多巴胺,合并左心功能不全者加用硝酸甘油.

13 cases with AMI of left ventricular inferior wall complicaled with risht ventricular myocardial infarction (RVMI) were reported. ECG of all patients showed ST segment elevations were more than 1 mm in one or more leads of v3R-v6R. Hemodynamic studies had been done on 4 cases and showed that right atrial pressure were greater than 1. 3 kPa and right ventriwlar end diastolic pressure had characteristic 'squre root sign'. Cli nically. AMI patients with right ventricular failure and/or shock are highly indicative of complication with RVMI. And hemodynamic studies and ECG should be done to confirm or rule out the diagosis, The principles of treatment are adequate amount of fluid infusion , dopamine for the shock state, and nitroglycerin to the pa-tients with left ventricular failure.