急性右心室心肌梗死围术期常见并发症管理专家共识

Expert Consensus on Perioperative Management of Complications in Acute Right Ventricular Myocardial Infarction

摘要

急性右心室心肌梗死(RVMI)是急性心肌梗死的一种重要而独特的类型,其主要临床表现为右心衰竭(如低血压和颈静脉充盈)。RVMI患者在经皮冠状动脉介入治疗(PCI)围术期常合并血流动力学不稳定和心律失常等并发症,导致较高死亡率。因此,加强RVMI患者直接PCI围术期常见并发症的管理尤为重要。本文通过回顾RVMI的病因、病理生理机制、临床表现及诊断,探讨低血压、休克、心律失常和其他并发症的管理策略,旨在形成专家共识,为改善RVMI直接PCI围术期的管理提供参考依据。

Abstract

Acute right ventricular myocardial infarction (RVMI) is an important and distinct type of acute myocardial infarction, whose main clinical manifestations include right heart failure (such as hypotension and jugular vein distension). Patients with RVMI often have complications such as hemodynamic instability and arrhythmia during the perioperative period of percutaneous coronary intervention (PCI), leading to a high mortality rate. Therefore, it is particularly important to strengthen the management of common perioperative complications in RVMI patients undergoing primary PCI. By reviewing the etiology, pathophysiological mechanism, clinical manifestations and diagnosis of RVMI, this article explores the management strategies for hypotension, shock, arrhythmia and other complications, aiming to form expert consensus and provide a reference for improving the perioperative management of direct PCI in RVMI.

关键词

右心室心肌梗死 / 心力衰竭 / 血流动力学 / 心律失常

Key words

right ventricle myocardial infarction (RVMI) / heart failure / hemodynamics / arrhythmia

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