冠状动脉造影正常的心肌梗死后室壁瘤11例分析

目的 探讨冠状动脉造影正常的心肌梗死后室壁瘤形成病人的临床特征及发病机制。方法 回顾性分析11例冠状动脉造影正常的心肌梗死后室壁瘤形成病人的临床资料及随访结果。结果 同期经左心室造影证实有室壁瘤的急性心肌梗死病人202例,冠状动脉正常的后室壁瘤11例,比例为5.4%（11/202）。均为男性,有大量吸烟史,无梗死前心绞痛史。11例均未行经冠状动脉介入术治疗,1例病人行尿激酶溶栓治疗。随访6个月～2年均存活。结论 心肌梗死后室壁瘤形成可发生于冠状动脉造影正常的病人,多见于男性及大量吸烟病人,发病机制可能与冠状动脉痉挛、侧支循环不能及时有效建立等有关。

Clinical analysis of ventricle aneurysm post myocardial infarction with normal coronary arteriography

Objectives To analyse the characteristics of ventricle aneurysm post myocardial infarction with normal coronary arteriograph and elucidate its mechanisms. Methods The results of coronary arteriography and some correlated materials in 11 patients with ventricle aneurysm post myocardial infarction with normal coronary arteriography enrolled from July 2000 to July 2005 were analysed. Results The patients with ventricle aneurysm post myocardial infarction and normal coronary arteriography accounted for 11/202(5.45%) patients. 1 patients had patency of infarction-related coronary artery by intravenous thrombolytic. The 11 patients were severity smokers but without of angina pectoris. Conclusions Ventricle aneurysm post acute myocardial infarction can be found in patients with normal coronary arteriography, most of them are men and severity smokers, and have no angina pectoris. Mechanisms are probably associated with coronary spasm and/or thombosis formation, and poor collateral circulation and well preserved contraction of viable myocardium.