急性心肌梗死冠脉支架术后迟发假性室壁瘤超声表现1例
Chinese Journal of Ultrasonography（2014）
Abstract
患者男,76岁.因急性下壁、后壁心肌梗死16 h急诊入院.心电图Ⅱ、Ⅲ、avF导联ST段抬高,心肌梗死图形.急诊冠状动脉造影示:冠脉多支病变,右冠状动脉(RCA)自中段完全闭塞.遂行经皮冠状动脉介入治疗,术后血流TIMI 3级,ST段回落.入院后第3d超声心动图示:左房内径34 mm,左室内径47 mm,左室射血分数52.94％,左室壁增厚,二、三尖瓣轻度关闭不全,主动脉瓣轻度关闭不全,左室节段性室壁运动异常,未见心室壁瘤.1个月后胸闷、胸痛复发,含服“硝酸甘油”持续不缓解而再次住院.查体:血压120/88 mmHg(1mmHg=0.133 kPa),双侧颈静脉充盈怒张,心界向左下扩大.
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