以晕厥为首发表现的急性心肌梗死合并心脏破裂一例

A Case of Acute Myocardial Infarction Presenting with Syncope as the Initial Symptom and Complicated with Cardiac Rupture

摘要: 心脏破裂是急性心肌梗死最致命并发症之一，起病凶险，死亡率极高。本研究报告一例61岁女性患者，因“发作性意识不清2天”入住神经内科，初步诊断为“晕厥”，后经心电图及心肌酶学检查确诊为急性下壁、后壁心肌梗死，病程中合并心脏破裂、心包压塞、心源性休克。经由多学科团队协作，在权衡出血与血栓风险后制定个体化保守治疗方案，患者病情稳定后出院，并于后期成功行冠状动脉介入治疗。

Abstract: Cardiac rupture is one of the most lethal complications of acute myocardial infarction, with a perilous onset and extremely high mortality rate. This study reports a case of a 61-year-old female patient who was admitted to the neurology department due to “2 days of episodic unconsciousness”. The initial diagnosis was “syncope”. Later, electrocardiogram and myocardial enzyme tests confirmed acute inferior and posterior myocardial infarction, with complications of cardiac rupture, pericardial tamponade, and cardiogenic shock during the course of the disease. Through multidisciplinary team collaboration, an individualized conservative treatment plan was formulated after weighing the risks of bleeding and thrombosis. The patient was discharged after stabilizing her condition and underwent successful coronary artery intervention therapy later.