Successful emergency surgical intervention in acute non-ST-segment elevation myocardial infarction with rupture: A case report.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Xing-Po Li, Zi-Shan Wang, Hong-Xia Yu, Shan-Shan Wang
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Abstract

Background: The incidence of acute myocardial infarction (AMI) is rising, with cardiac rupture accounting for approximately 2% of deaths in patients with acute ST-segment elevation myocardial infarction (STEMI). Ventricular free wall rupture (FWR) occurs in approximately 2% of AMI patients and is notably rare in patients with non-STEMI. Types of cardiac rupture include left ventricular FWR, ventricular septal rupture, and papillary muscle rupture. The FWR usually leads to acute cardiac tamponade or electromechanical dissociation, where standard resuscitation efforts may not be effective. Ventricular septal rupture and papillary muscle rupture often result in refractory heart failure, with mortality rates over 50%, even with surgical or percutaneous repair options.

Case summary: We present a rare case of an acute non-STEMI patient who suffered sudden FWR causing cardiac tamponade and loss of consciousness immediate before undergoing coronary angiography. Prompt resuscitation and emergency open-heart repair along with coronary artery bypass grafting resulted in successful patient recovery.

Conclusion: This case emphasizes the risks of AMI complications, shares a successful treatment scenario, and discusses measures to prevent such complications.

急性非st段抬高型心肌梗死伴破裂急诊手术成功1例报告。
背景:急性心肌梗死(AMI)的发病率正在上升,在急性st段抬高型心肌梗死(STEMI)患者中,心脏破裂约占死亡人数的2%。心室游离壁破裂(FWR)发生在大约2%的AMI患者中,在非stemi患者中尤为罕见。心脏破裂的类型包括左心室FWR、室间隔破裂和乳头肌破裂。FWR通常会导致急性心包填塞或机电分离,在这种情况下,标准的复苏措施可能无效。室间隔破裂和乳头肌破裂常导致顽固性心力衰竭,死亡率超过50%,即使采用手术或经皮修复方案。病例总结:我们报告了一例罕见的急性非stemi患者,在接受冠状动脉造影之前,突然发生FWR导致心脏填塞和意识丧失。及时复苏和紧急心脏内直视修复以及冠状动脉旁路移植术使患者成功康复。结论:本病例强调AMI并发症的风险,分享了一个成功的治疗方案,并讨论了预防AMI并发症的措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
World Journal of Clinical Cases
World Journal of Clinical Cases Medicine-General Medicine
自引率
0.00%
发文量
3384
期刊介绍: The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.
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