Acute RVMI With IWMI And IWMI Clinical Feature Analyse

Objective:To investigated the clinical feature diagnosis and treatment for RVMI,through researching the clinical character and treatment,as well as prognosis of patients with ST segment elevationin of RVMI and RVMI with IWMI.Method:The 123 patients of IWMI,who were slected to the first affilia -ted hosptal of Guangxi medical universty from june 2004 to june 2007.According to characterristic change of the 18 lead Electrocardiographic manifestations,we analyzed retrospectively the date of 37 patients of RVMI and IWMI and 51 patients of IWMI from 123 patients of IWMI,compared the result of risk factors of coronary heart disease,clinical manifestation,the electrocardiographic and the cardiac muscle enzyme,complicating disease,complication,motality rate of the two groups with statistics.Result:1.There were no significant differences of the gender,age,smoking,fatness,hyperlipoidemia,hypertension,diabetes mellitus,coronary heart disease family history in the two groups,(p＞0.05).2.There are no significant differences of chest pain,decompensation,nausea and anabole in the two groups,(p＞0.05).But hypopiesia,disten -tion of jugular vein,Kussmal sign positive have significant differences.The RVMI patients with IWMI will be more frequently have hypopiesia,distention of jugular vein, Kussmal sign positive than IWMI patients.3.Heart failure,Cardiac shock,Auricular fibrillation,Atrioventricular heart-block of gradeâ…¢have significant differences(p＜0.05).The RVMI patients with IWMI will be more frequently have Heart failure,Cardiac shock,Auricular fibrillation,Atrioventricular heart-block of gradeâ…¢,ventricular tachycardia than IWMI patients.Likewise,there were no significant differences of bradyrhythmia,atrioventricular heart-block of gradeⅠ～Ⅱ,ventricular fibrillation in the two groups(p＞0.05).4.â…¢ST↑/â…¡ST↑＞1,V₂ST↓/a VF ST↑≤0.5,there are significant differences of two groups(p＜0.05),The RVMI patients with IWMI is higher than IWMI patients.5.The peak value of CK and the peak value of CK-MB have significant differences(p＜0.05),The CK and CK-MB value of RVMI patients with IWMI is higher than IWMI patients.6.Fluid expansion,Dopamine and dobutamine applying have significant differences(p＜0.05),The Fluid expansion,Dopamine and dobutamine applying of RVMI patients with IWMI is higher than IWMI patients.There were no significant differences of Thrombolysis,PCI,install cardiac pacemaker in the two groups(p＞0.05).7.Death rate in two groups have significant differences(p＜0.05),The RVMI patients with IWMI is higher than IWMI patients.Conclusion:1.RVMI is a special type of the AMI,and simple RVMI is rare, the patient with IWMI should pay attention to the RVMI.2.The hypopiesia,distention of jugular vein,Kussmal sign positive are very easy to see and the complication,such as heart failure,cardiac shock,Atrioventricul- ar heart-block of gradeâ…¢,ventricular tachycardia have been notablely increased in RVMI.Hemodynamics obstruction and arrthythmia are very impotant reason to high complication in hospital.3.Electrocardiographic is a practical,no wounded,repeated and cheap method which to dianose the AMI.â…¢ST↑/â…¡ST↑＞1 and V₂ST↓/aVF ST↑≤0.5 is a important assistant diadynamic criteria in RVMI with IWMI.4.Maybe the abnormal peak value of CK and CK-MB in IWMI is a forecast factor in RVMI and IWMI.5.The specificity of treatment of RVMI are fluid expansion.6.Increase in the death rate in hospitol of RVMI with IWMI,the heart failure,cardiac shock,malignant ventricular arrhythmia are greatly important reasons for death.