雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

A Case of Oozing Rupture followed by a Pseudo-like Ventricular Aneurysm due to Acute Inferior Myocardial Infarction Haruhiro Toko 1 , Satoshi Shimada 1 , Shinichiro Nishida 1 , Tatsuji Kono 2 , Keishiro Kawamura 2 , Masafumi Morita 3 , Seiichiro Minohara 4 1Division of Cardiology, Syunjyu-kai Nishi Osaka Hospital 2The Third Division, Department of Internal Medicine, Osaka Medical College 3Department of Cardiovascular Surgery, Minami Osaka Hospital 4Department of Cardiovascular Surgery, Nishinomiya Watanabe Hospital Keyword: 急性下壁心筋梗塞 , oozing型心破裂 , 仮性心室瘤 , acute inferior myocardial infarction , oozing type free wall rupture , pseudoaneurysm pp.815-819
Published Date 1998/8/15
DOI https://doi.org/10.11477/mf.1404901747
  • Abstract
  • Look Inside

A 61-year-old male was admitted to our hospital with chest pain and dyspnea. An electrocardiogram showed an abnormal Q wave and ST elevation at II, III, aVF andV4-6. The echocardiography showed hypokinesis at the left ventricular inferior wall and high echoic pericardial effusion. These findings suggested acute inferior myocar-dial infarction (MI) accompanied by left ventricular free wall rupture. The emergent coronary angiography demonstrated total occlusion of the posterodescending branch of the right coronary artery. One day after the patient's admission, pericardiocentesis was performed because of hemodynamic instability in spite of volume loading and low dose cathecolamine infusion.Hemodynamics improved as a result of the removal of 110 ml of bloody effusion. Left ventriculography and echocardiography performed 3 weeks after the onset of MI demonstrated an aneurysm at the inferior wall of the left ventricle. Because of difficulty with differentiation of true or false aneurysm, aneurysmectomy was perfor-med 1 month after onset, which showed that it was a true aneurysm. These findings suggest that: 1) an echocardiographic study should be performed before the initiation of reperfusion therapy for the treatment of acute myocardial infarction. 2) Oozing type free wall rupture may be partly stabilized by pericardiocentesis without an emergency operation. 3) Left ventricular aneurysm with a small mouth makes it dificult to differentiate between true or false aneurysm based on findings of echocardiography and/or left ventricurogra-phy, especially in cases of inferior aneurysms.


Copyright © 1998, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

関連文献

もっと見る

文献を共有