Résumé
Papillary muscle rupture is one of the common complications of acute myocardial infarction. We report a case of 77-years-old man with an acute posterior papillary muscle rupture without obvious coronary artery disease. The patient presented with cardiogenic shock and pulmonary edema. Emergency coronary angiogram showed no obstruction in coronary arteries. An echocardiogram and right heart catheterization data suggested acute mitral regurgitation caused by ruptured posterior papillary muscle. Percutaneous cardiopulmonary support was induced because of his unstable hemodynamics, and then emergency mitral valve replacement was performed. Intraoperative findings suggested some ischemic changes in the posterior papillary muscle. Pathologically, both old and new ischemic lesion presented in the same papillary muscle. Moreover, severe thickening of a small vessel wall was noted. This case presented one of the possible mechanisms of so-called idiopathic papillary muscle rupture.
Résumé
@# ObjectiveTo investigate the effects of Jiuqiang Naoliqing(JNQ) on the morphology of the vital organs(the brain,kidney and heart) in acute hypertension rats.MethodsThe model was established by L-NG-nitro arginine(L-NNA),which can inhibit the synthesis of nitric oxide(NO).Affected animals were administrated with high,medium or low dose of JNQ while nifedipine was used as the positive control.Effects on cardiac function and morphology of the vital organs were investigated.Results2 weeks after the establishment of the model,the affected rats had a 36% higher blood pressure compared with the control group.The acute hypertension rats showed significant pathologic changed in the brain,kidney and heart,while there was no obvious difference in the heart rate,electrocardiaogram,and blood pressure between the administrated groups.After treatment with JNQ,the contraction force and the oxygen extraction of the myocardiocytes were significantly reduced and the increasing velocity of the left ventricular pressure was decreased.The brain,kidney and heart showed improvement in pathology analysis to different levels.ConclusionAlthough it has no obvious effects on the heart rate and blood pressure in acute hypertension rats,JNQ can decrease the oxygen extraction in myocardiocytes and can obviously alleviate brains,kidneys and hearts pathologic changes.