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一般说心肌梗塞,均指左室梗塞(LVI)。因常规心电图(EKG)对右室梗塞(RVI)的诊断无定位特异性,故临床上常漏诊。七十年代以来,血液动力学监测使RVI的临床诊断变为可能。近年来,放射性核素心肌闪烁扫描技术和EKG新导联的应用,使RVI诊断渐臻完善,因RVI与LVI的诊断和治疗有不同之处,故将RVI诊治作以下综述。一、RVI的发病率 RVI发病率各家报告不一,归纳起来:(1)Wartman和Erhardt等分别于1948和1974年尸解报道,在急性心肌梗塞(AMI)者中RVI占14～43％;(2)七十年代Cohn和Lorell及Cintron以血液动力学鉴测结果报道,RVI仅占AMI病人韵3—17％但这类统计只能代表临床上显著的右室功能不全的发生率,而不能代表解剖学的发生率;(3)Rigo、Sharpe及Croft等近年来应用放射性核素显象技术检查结果报道,
Generally speaking, myocardial infarction, both refers to left ventricular infarction (LVI). Because of conventional electrocardiogram (EKG) diagnosis of right ventricular infarction (RVI) without specificity, it is often missed clinically. Since the seventies, hemodynamic monitoring has made the clinical diagnosis of RVI possible. In recent years, radionuclide myocardial scintigraphy and EKG new lead application, RVI diagnosis getting better, because RVI and LVI diagnosis and treatment are different, so the RVI diagnosis and treatment for the following review. First, the incidence of RVI RVI incidence of various reports vary, summed up: (1) Wartman and Erhardt, respectively, in 1948 and 1974 autopsy reported that in acute myocardial infarction (AMI), RVI accounted for 14 to 43% ; (2) In the seventies Cohn and Lorell and Cintron reported haemodynamic results, RVI accounted for only 3-17% of patients with AMI rhyme, but these statistics can only represent the clinically significant incidence of right ventricular dysfunction, But can not represent the incidence of anatomy; (3) Rigo, Sharpe and Croft in recent years, the application of radionuclide imaging test results reported,