CAJ | 학술논문

目的：探讨急性心肌梗死(AMI)合并少量心包积液诱发心脏压塞的发病机制和临床特征。方法：分析1例病例并复习文献。结果：心包压塞是心包积液累积、心包腔压力增加共同作用的结果。通常150~2000ml心包积液可能引起心脏压塞，但在AMI时即使少量心包积液如果引起心包内压力迅速升高，压力作用于心腔，心脏各腔的收缩和舒张以及相互协调功能严重受损，产生类似心包压塞症状。结论：大面积心肌梗死早期可出现心包积液，若出现心脏压塞症状，不宜只关注心包积液量多少，宜尽早心包穿刺减压，改善预后。
목적：탐토급성심기경사(AMI)합병소량심포적액유발심장압새적발병궤제화림상특정。방법：분석1례병례병복습문헌。결과：심포압새시심포적액루적、심포강압력증가공동작용적결과。통상150~2000ml심포적액가능인기심장압새，단재AMI시즉사소량심포적액여과인기심포내압력신속승고，압력작용우심강，심장각강적수축화서장이급상호협조공능엄중수손，산생유사심포압새증상。결론：대면적심기경사조기가출현심포적액，약출현심장압새증상，불의지관주심포적액량다소，의진조심포천자감압，개선예후。
Objective:This study was performed to discuss the pathogenesis and clinical features of acute myocardial infarction with small pericardial effusions presenting as cardiac tamponade. Methods:One case was analyzed and relevant literature was reviewed. Results:Cardiac tamponade is the decompensated phase of cardiac compression caused by effusion accumulation and the increased intrapericardial pressure. The volume of fluid causing tamponade varies from 150 ml to 2000 ml. While in acute myocardial infarction, small effusions might cause intrapericardial pressure increased rapidly. With the damage of cardiac systolic and diastolic function, the rapidly increased intrapericardial pressure might cause cardiac function disorder badly and present with tamponade. Conclusions:When acute myocardial infarction with pericardial effusions present as cardiac tamponade, pericardiocentesis should be applied as soon as possible, even small pericardial effusions.