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为了对右心室梗塞的发生率、临床特征及病程予以估价,本文对96例确诊为急性心肌梗塞的患者进行了10个月的研究。在44例急性下壁心肌梗塞的患者中,16例有右室功能不良的临床征象。库斯毛耳(Kussmaul)氏征均呈阳性,12例有右心室第三或第四心音。9例右房及右室舒张末期压有吸气性增高。1例发生心室颤动,3例出现房室传导阻滞。此16例患者于梗塞后三个月均存活。其病程及三个月存活率与其他下壁梗塞患者无差异。约有1/3下壁心肌梗塞患者具右室梗塞的临床征象,通常不改变近期预后。自从开始描述右心室梗塞以来,由于发生率增加,其临床症状已被认识。Cohn 等描述的全身静脉压增高、肺野清晰,系统性低血压及房室传导阻滞等临床表现已为人们熟知。右心导管或导管闪烁造影(gatedScintigraphy)及99m 锝焦磷酸盐心肌映相能进一步证实诊断。右心室梗塞的临床发生率为所有心肌梗塞病例的3～8%,而病理学及放射性核素研究则发现下壁心肌梗塞中右室受累的发生率达24～37%。大多数作者强调了创伤性诊断程序及右心室梗塞的严重并发症。本研究旨在讨论对右心室梗塞的临床诊断、发生率及病程作出展望性的估价。
In order to evaluate the incidence, clinical characteristics and duration of right ventricular infarction, we conducted a 10-month study of 96 patients with acute myocardial infarction. Of the 44 patients with acute inferior myocardial infarction, 16 had clinical signs of right ventricular dysfunction. Kussmaul’s sign was positive, and 12 had third or fourth heart sounds in the right ventricle. Nine cases of right atrial and right ventricular end diastolic pressure increased aspiration. Ventricular fibrillation occurred in 1 case and atrioventricular block was found in 3 cases. All 16 patients survived three months after infarction. The course of disease and three-month survival rate and other patients with inferior wall infarction no difference. About 1/3 of patients with inferior myocardial infarction with clinical signs of right ventricular infarction, usually does not change the recent prognosis. Since the beginning of the description of right ventricular infarction, its clinical symptoms have been recognized as a result of the increased incidence. The clinical manifestations of systemic venous hypertension, clear lung fields, systemic hypotension and atrioventricular block, as described by Cohn et al., Are well known. Right heart catheterization or catheter scintigraphy (gatedScintigraphy) and 99mTc-pyrophosphate myocardial imaging can further confirm the diagnosis. The clinical incidence of right ventricular infarction is 3-8% of all cases of myocardial infarction, whereas pathology and radionuclide studies have found that the incidence of right ventricular involvement in inferior myocardial infarction is 24-37%. Most authors highlight traumatic diagnostic procedures and serious complications of right ventricular infarction. This study aimed to discuss the clinical diagnosis of right ventricular infarction, the incidence and duration of making a prospective valuation.