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1、MyocardialInfarction心肌梗死Myocardialinfarction心肌梗死Myocardialinfarction(MIorAMIforacutemyocardialinfarction),alsoknownasaheartattack心臟病發(fā)作,occurswhenthebloodsupplytopartoftheheartisinterrupted,resultingischemiaandoxygenshortage,ifleftuntreatedforasufficientperiod,cancausedamageand/ormyocar
2、diuminfarction.Angina心絞痛asaresultofischemiacausesreversiblecellularinjury,andinfarctionistheresultofsustainedischemia,causingirreversiblecellulardeath.Classification分類Acutemyocardialinfarctionisatypeofacutecoronarysyndrome急性冠脈綜合征.Theacutecoronarysyndromesinclude:unstableangina(UA)不穩(wěn)定型心
3、絞痛.STsegmentelevationmyocardialinfarction(STEMI)ST段抬高性心梗non-STsegmentelevationmyocardialinfarction(NSTEMI)非ST段抬高性心梗MyocardialinfarctionInfarctionsaredescribedbytheareaofoccurrenceasanterior前壁,posterior后壁,inferior下壁orlateral側(cè)壁wallinfarctions.InferiorMIisalsocalledadiaphragmaticMI(DMI)膈肌
4、心梗Commoncombinationofareasaretheanterolateral前側(cè)壁心肌梗塞oranteroseptal(房室)隔前的MI.Pathophysiology病理生理Themostcommontriggeringeventisthedisruption破損ofanatheroscleroticplaque粥樣硬化斑塊inanepicardialcoronaryartery.Plaquescanbecomeunstable,rupture破裂,andadditionallypromoteathrombus血栓(bloodclot)thatocc
5、ludes阻塞theartery.Whenasevereenoughplaqueruptureoccursinthecoronaryvasculature,itleadstomyocardialinfarction.Pathophysiology病理生理Dependingonthelocationoftheobstructioninthecoronarycirculation,differentzonesoftheheartcanbecomeinjured.Anocclusionoftheleftanteriordescendingcoronaryartery(LA
6、D)左冠狀動脈前降支willresultinananteriorwallmyocardialinfarct前壁心肌梗死.Infarctsofthelateralwall側(cè)壁心肌梗死arecausedbyocclusionoftheleftcircumflexcoronaryartery(LCx)冠狀動脈左回旋支.Bothinferiorwallandposteriorwallinfarctions下壁和后壁心梗maybecausedbyocclusionofeithertherightcoronaryartery右冠狀動脈ortheleftcircumflexart
7、ery左冠狀動脈回旋支,dependingonwhichfeedstheposteriordescendingartery.Rightventricularwallinfarcts右心室壁梗死arealsocausedbyrightcoronaryartery右冠狀動脈occlusion.Pathophysiology病理生理Thedegreeofpreestablishedcollateralcirculation側(cè)支循環(huán)提前建立alsodeterminetheseverityofinfarction.Inanindividualwithahistoryofh
