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右心室心肌梗塞(RVMI)并不少见。但目前临床上用于诊断心肌梗塞的方法不易确诊,故目前能正确及时诊断者不多。RVMI以其特有的血液动力学改变,诊断方法和处理而与常见的左心室心肌梗塞相区别。一、临床表现和血液动力学改变右心室梗塞病人临床上常有左心室下(后)壁梗塞的证据。典型病例发现有低血压或休克,有较明显的大循环静脉充盈而无呼吸困难,因而呈颈静脉充盈、Kussmaul’s征阳性,颈静脉V波明显、中心静脉压升高;X线肺野多清晰,个别病例由于右心室乳头肌功能障碍或破裂造成兰尖瓣关闭不全。Cohn等首先报导6例RVMI的血液动力学特征性改变。右房平均压是20.2mmHg(范围16～28),3例右心室收缩压和肺动脉压正常,而肺动脉舒张压
Right ventricular myocardial infarction (RVMI) is not uncommon. However, the current clinical method for the diagnosis of myocardial infarction is not easy to diagnose, so at present it is correct and timely diagnosis of small. RVMI with its unique hemodynamic changes, diagnostic methods and treatment and common left ventricular myocardial infarction phase difference. First, the clinical manifestations and hemodynamic changes in patients with right ventricular infarction often left ventricular (posterior) wall infarction evidence. Typical cases were found to have hypotension or shock, more obvious filling of the circulatory vein without respiratory difficulties, which was filling the jugular vein, Kussmaul’s sign positive, jugular vein V wave was significantly elevated central venous pressure; , A few cases of right ventricular papillary muscle dysfunction or rupture caused by the lack of closure of the blue valve. Cohn et al. First reported hemodynamic changes in six patients with RVMI. Right atrium mean pressure was 20.2mmHg (range 16-28), 3 cases of right ventricular systolic pressure and pulmonary arterial pressure were normal, and pulmonary artery diastolic pressure