急性心肌梗死合并严重3支病变开通靶血管后合并心源性休克再次干预非靶血管1例

赵希军; 李景森; 徐会圃

doi:10.13201/j.issn.1001-1439.2023.08.014

急性心肌梗死合并严重3支病变开通靶血管后合并心源性休克再次干预非靶血管1例

- 滨州医学院附属医院心内科(山东滨州，256603)

详细信息

通讯作者: 徐会圃, E-mail: byfyxnk@163.com

中图分类号: R542.2

收稿日期: 2022-10-12

刊出日期: 2023-08-13

Acute myocardial infarction combined with severe lesions of the three coronary arteries and cardiogenic shock after opening of target blood vessels, and intervention in non-target blood vessels again: a case report

- Department of Cardiology, Binzhou Medical University Hospital, Binzhou, Shandong, 256603, China

More Information

Corresponding author: XU Huipu, E-mail: byfyxnk@163.com

Received Date: 12 October 2022

Publish Date: 13 August 2023

摘要

摘要: 1例老年男性患者因持续胸闷1 h入院。既往有糖尿病和高血压病史。心电图示Ⅱ、Ⅲ、AVF、V₇~V₉导联ST段抬高0.1~0.2 mV。诊断为急性ST段抬高型心肌梗死，立即进行急诊经皮冠状动脉介入治疗(PCI)，开通梗死相关动脉右冠状动脉左室后支。患者PCI后出现左心衰竭和心源性休克，在主动脉内球囊反搏支持下再次行急诊PCI处理罪犯血管左前降支。经积极治疗后，患者病情好转出院。
- 急性心肌梗死 /
- 心源性休克 /
- 经皮冠状动脉介入术
Abstract: An elderly male patient was admitted with persistent chest tightness for 1 hour. He had a previous history of diabetes mellitus and hypertension. ECG showed Ⅱ, Ⅲ, AVF, V₇-V₉lead ST segment elevation up to 0.1-0.2 mV. Acute ST segment elevation myocardial infarction was diagnosed, and emergency percutaneous coronary intervention(PCI) was performed immediately, to open the infarction-related artery, posterior left ventricle branch of right coronary artery. After PCI, left ventricular failure and cardiogenic shock were developed. We handled the left anterior descending artery of the culprit vessel in second emergency PCI supported by intra-aortic balloon pump(IABP). After that, the patient's condition improved and was discharged from the hospital.
- acute myocardial infarction /
- cardiogenic shock /
- percutaneous coronary intervention

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图 1 心电图检查(入院时)

Figure 1. 18 leads ECG

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图 2 第1次急诊PCI

Figure 2. First emergency PCI

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图 3 心电图检查(心衰发作时)

Figure 3. 12 leads ECG

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图 4 第2次急诊PCI

Figure 4. Second emergency PCI

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