中国卒中杂志 ›› 2024, Vol. 19 ›› Issue (3): 337-342.DOI: 10.3969/j.issn.1673-5765.2024.03.013

• 病例讨论 • 上一篇    下一篇

延髓“心”形梗死合并急性心肌梗死1例报道

郝先泽1,刘国庆1,姜英2,吴晓娟1,张小乔3   

  1. 1 十堰 442000 湖北医药学院研究生院
    2 湖北省襄阳市襄州区人民医院全科医学科
    3 湖北医药学院附属太和医院综合医疗科
  • 收稿日期:2023-06-12 出版日期:2024-03-20 发布日期:2024-03-20
  • 通讯作者: 张小乔 little_bridge@126.com

“Heart” Shaped Medullary Infarction Complicated with Acute Myocardial Infarction: A Case Report

HAO Xianze1, LIU Guoqing1, JIANG Ying2, WU Xiaojuan1, ZHANG Xiaoqiao3   

  1. 1 Graduate School of Hubei University of Medicine, Shiyan 442000, China
    2 Department of General Family Medicine, Xiangzhou District People’s Hospital, Xiangyang 441100, China
    3 Department of Comprehensive Medicine, Taihe Hospital Affiliated to Hubei University of Medicine, Shiyan 442000, China
  • Received:2023-06-12 Online:2024-03-20 Published:2024-03-20
  • Contact: ZHANG Xiaoqiao, E-mail: little_bridge@126.com

摘要: 脑梗死和急性心肌梗死均属于缺血性血管疾病,有共同的危险因素,两者可能同时或相继发病。延髓梗死诱发自主神经功能紊乱影响心脏神经,梗死后的应激反应也会导致心肌缺血梗死。本文报道1例双侧延髓内侧梗死合并急性心肌梗死患者的诊治过程,患者在疾病早期MRI检查未显影,数天后复查才呈现“心”形梗死灶,经过抗血小板聚集、调脂治疗仍有肢体偏瘫。本病例强调了脑梗死患者应进行详细的体格检查、辅助检查并全面评估心脏指标,防止误诊、漏诊。

关键词: 延髓内侧梗死; 双侧延髓; 急性心肌梗死; 脑心综合征

Abstract: Cerebral infarction and acute myocardial infarction are both ischemic vascular diseases, with common risk factors, and may occur simultaneously or successively. Medullary infarction induces autonomic nervous dysfunction that affects cardiac nerves, and stress response after infarction can also lead to myocardial ischemic infarction. This paper reported the diagnosis and treatment process of a patient with bilateral medial medullary infarction complicated with acute myocardial infarction. The patient had no lesions on the MRI examination in the early stage of the disease, and the “heart” shaped infarct was found after several days of MRI reexamination. After antiplatelet aggregation and lipid-regulating treatment, there was still limb hemiplegia. This case emphasizes that patients with cerebral infarction should be given detailed physical examination, accessory examination and comprehensive evaluation of cardiac indicators to prevent misdiagnosis and missed diagnosis.

Key words: Medial medullary infarction; Bilateral medulla oblongata; Acute myocardial infarction; Cerebrocardiac syndrome

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