| Background Although the incidence of acute myocardial infarction complicated with ventricular septal perforation is not high, but in clinic is serious and deadly complications, once happened, treatment effect is very poor, mortality is extremely high. At home and abroad the clinical study of acute myocardial infarction complicated with ventricular septal perforation, were retrospectively analyzed the clinical characteristics of patients with acute myocardial infarction complicated with ventricular septal perforation, treatment strategies and prognostic factors, is conducive to improve the survival rate of the patients to improve the prognosis of patients, is very important to guide clinical work.Aims To investigate clinical symptoms,, efficacy and prognosis of acute myocardial infarction(AMI) complicated by ventricular septal rupture(VSR).Methods Clinical data was collected from the first affiliated hospital of Anhui Medical University during January 2008 and January 2014, 22 patients of AMI complicated by VSR were retrospectively analyzed.Results Of 22 patients of acute myocardial infarction with ventricular septal perforation, there were 11(50.00%) patients with hypertension, 4(18.18%) cases with hyperlipemia,10(45.45%) patients with type 2 diabetes, 7(31.82%) patients were smoking, and 3(13.64%) patients accompanied with angina. 14(63.64%) cases were local or extensive anterior myocardial infarction, 4(18.18%) cases were anteriorcombined with high sidewalls or inferior wall, 2(9.09%) cases were inferior wall, 2(9.09%) case was inferior wall combined with right ventricular or posterior wall. In addition, there were 7(31.82%) cases merger with aneurysm formation. For the NYHA, 9(40.91%) each of grade II and grade III,and 4(18.18%) cases were of grade IV. Diameter of VSR was measured by echocardiography, mainly 4 ~ 19 mm, 16(72.72%) cases of VSR near the apex, 3(13.64%) cases were located in the back interventricular septum, 2(9.09%) in the muscle portions of ventricular septal,and 1(4.55%) case with multiple performation. 1(4.55%) patient was cardiac rupture. 15(68.18%) patients died after single conservative treatment, 2(9.09%) died after intra-aortic balloon IABP support treatment. However, only 5 patients survived, one(4.55%) of them received elective stent implantation after septal occluder and other four(18.18%) received surgery.Conclusion AMI patient merger with VSR was rare in the clinical, and the major of them with local or extensive anterior myocardial infarction, which developed into acute heart failure rapidly, cardiogenic shock even,with high mortality and poor prognosis after single medical treatment. Early intervention or surgical treatment will help to improve the prognosis of patients,thereby improve patient survival. |
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