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心肌梗塞后出现杂音并不少见。需加鉴别的情况包括乳头肌功能障碍或断裂、室间隔破裂和左心室扩大导致二尖瓣关闭不全。它们的临床病程、预后和治疗有很大不同。 1.乳头肌功能障碍:杂音可在收缩中期、后期或全收缩期出现,取决于乳头肌的功能状态和纤维化的程度。杂音往往在梗塞后早期就出现,通常是在梗塞后头5天。杂音倾向于逐日改变,在三分之二的病人,其响度仅1～2/6级,因此
Appear noise after myocardial infarction is not uncommon. Need to add the identification of cases, including papillary muscle dysfunction or fracture, rupture of the ventricle and left ventricular enlargement lead to mitral regurgitation. Their clinical course, prognosis and treatment are very different. 1. Papillary muscle dysfunction: murmurs may appear in the mid-contractions, late or total systole, depending on the functional status of papillary muscle and the extent of fibrosis. Noise often appears early after infarction, usually in the first 5 days after infarction. Noise tends to change day by day, and in two thirds of patients, its loudness is only 1 to 2/6, so