简介:古巴卫生部的调查显示,古巴健在的百岁以上老人已达1551人,比去年增加10人,其中年龄最大的是一名126岁老妇。
简介:目的探讨酷似急性心肌梗死(AMI)的急性重症病毒性心肌炎(AFVM)的诊断和治疗。方法收集临床表现酷似心肌梗死(MI),经过冠状动脉造影(CAG)显示冠脉正常的AFVM14例,分析该病的发病机制、心电图特征、治疗及预后。结果经及时确诊并采取相应治疗后4例乏力、胸痛、心悸、气短等症状明显好转,心肌酶、心电图及心脏彩超恢复大致正常范围;2例发生阵发性心悸,发作时心电图示:非阵发性室性心动过速及室上性心动过速,室性期前收缩;4例发作性胸闷、胸痛,心电图示:ST-T改变(ST段下移0.1~0.2mV,T波低平伴切迹);1例心电图示三度房室传导阻滞;1例呈左束支传导阻滞;1例显示病理性Q波;l例因急性期而死亡。结论酷似MI的病毒性心肌炎其临床表现、心电图、心肌酶改变酷似AMI。着重把握临床资料,掌握客观诊断依据,积极合理诊治是值得临床医生重视的问题。
简介:目的观察心肌梗死急诊经皮冠状动脉介入(PCI)治疗的疗效及安全性.方法对14例急性ST段抬高心肌梗死(STEMI)患者在发病12h内行急诊PCI.其中急性前壁、急性前间壁心梗10例,急性下壁心梗4例.结果14例患者中,冠脉造影显示梗死相关动脉(IRA)为前降支8例,回旋支3例,右冠脉4例,13例患者(92.9%)介入治疗获得成功,置入支架15枚,全部获得TIMI血流3级.1例因术中发生室颤,经除颤转为窦性心律后家属放弃手术未能成功.结论对急性STEMI患者行急诊PCI治疗是积极有效的,安全性高,能明显提高患者生活质量,降低住院死亡率.
简介:Arrhythmogenicrightventriculardysplasia/cardiomyopathy(ARVD/C)ischaracterizedbyfibro-fattyreplacementoftherightventricle.However,thefeasibilityandsignificanceofmyocardialfibrosisdetec-tedbydelayedenhancement(DE)using3.0Tmagneticresonanceimaging(MRI)in.ARVD/Cisseldomlystudied.MethodsTwenty-sevenconsecutivepatientswereprospectivelyevaluatedforARVD/C.Magneticreso-nanceimagingwasperformedona3.0Tscanner.Tenminutesafterintravenousadministrationof0.2mmol/kgofgadodiamide,DE-MRIwasobtained.DiagnosisofARVD/CwasbasedupontheTaskForcecriteriaandin-cludedMRIfindings.ResultsSeventeen(59%)of27patientsmettheTaskForcecriteriaforARVD/C.Rightven-tricleDEwasfoundinall(100%)ARVD/Cpatientscomparedwithnone(0%)ofthe10patientswithoutARVD/C(P<0.001).AdditionalleftventricularDEwasfoundin8/17ARVD/Cpatientswhilewithoutleftventricularmor-phologicalandfunctionalabnormalitiesdetectedbyechocardiographyorMRI.ConclusionsDEusing3.0TMRIcouldeffectivelydetectmyocardialfibrosisintherightandleftventricularmyocardiuminARVD/Cpatients.DetectionofmyocardialfibrosismayhaveanimportantclinicalsignificanceinARVD/Cdiagnosis.Histologicalleftventriclein-volvementmaybeeasilymissedbyechocardiography.
简介:AbstractAnagedmalepatientwithcoronaryheartdiseasewhichhadbeentreatedwithcoronaryarterybypassgrafts(CABG)andadministrationofmetoprolol,presentedparoxysmalvertigointhepreviousthreeweeks.The24hourssynchronic12-leaddynamicelectrocardiography(DCG)revealedmanyepisodesofsinusarrestwhichmostlywerefollowedbyA-Vjunctionalorventricularescaperhythm,thelongestsinuspauselastingmorethan14.5secondswithnosymptom.Afterwithdrawalofmetoprolol,theDCGrevealedmuchlessepisodesofsinusarrestthanon-admission,butstillsomeA-Vjunctionalandventricularescapebeats.Sicksinussyndromeswasthendiagnosed,andasynchronousdual-chamberpacemaker(DDDR)wasimplantedtwoweeksafteradmission.
简介:心肌缺血再灌注损伤(myocardialischemiareperfusioninjury,MIRI)是指心肌组织缺血后再恢复灌注,缺血心肌的损害不仅没有好转反而出现反常增加的现象[1].MIRI是临床医生面临的一大难题[2-4].由于心外科手术需要无血、相对静止的环境,在体外循环、心脏停跳下进行,而体外循环心脏停跳下手术则需要阻断心脏供血,注入停跳液促使心脏停跳,心脏上操作完成后再恢复心脏血供,促使心脏复跳,因此体外循环下心脏停跳过程就是一个缺血再灌注损伤的过程.在经历体外循环后的心脏病患者术后恢复过程及远期疗效很大程度与缺血再灌注损伤相关,所以MIRI的研究具有重要的意义.但MIRI损伤的病理生理机制是复杂的,到目前为止都还不完全清楚,亦缺乏有效的治疗策略[5].
简介:1临床资料患者男性,92岁,以"反复胸闷、气短30年,加重6d"于2002年10月8日入院.患有冠心病30年,2002年10月2日因劳累及情绪激动后出现胸闷、气短,并伴有夜间明显喘憋,未治疗,10月8日喘憋加重就诊,心电图示窦性心律,左前分支传导阻滞,急性广泛前壁、侧壁心肌梗死(衍变期),入CCU治疗.