延髓“心”形梗死合并急性心肌梗死1例报道 “Heart” Shaped Medullary Infarction Complicated with Acute Myocardial Infarction: A Case Report

Abstract

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。 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.

Keywords

• 延髓内侧梗死
• 双侧延髓
• 急性心肌梗死
• 脑心综合征
• medial medullary infarction
• bilateral medulla oblongata
• acute myocardial infarction
• cerebrocardiac syndrome