Myocardial stunning

Introduction Myocardial stunning, also known as myocardial dysfunction after ischemia, means that myocardial transient ischemia has not caused myocardial necrosis, but mechanical resilience after reperfusion returns to normal blood flow requires hours, days or weeks. The phenomenon of complete recovery. Myocardial stunning may be a multifactorial process that is the result of interactions between cardiomyocyte abnormalities and multiple pathogenic mechanisms after ischemia.

Cause

Myocardial stunning may be a multifactorial process that is the result of interactions between cardiomyocyte abnormalities and multiple pathogenic mechanisms after ischemia. At present, there are two main etiology hypotheses of myocardial stunning, namely the calcium hypothesis and the oxygen free radical hypothesis.

an examination

Related inspection

Dynamic electrocardiogram (Holter monitoring) ECG

Ischemic myocardium resuscitates the surviving ventricular myocardium through coronary reperfusion. Although there is no myocardial necrosis, cardiac dysfunction lasts for more than 1 week (including myocardial contraction, high-energy phosphate bond reserve and ultrastructure are abnormal), and blood flow is restored. After that, the time of contraction and diastolic function is prolonged, and then gradually improves.

Differential diagnosis

Myocardial infarction: refers to the interruption of coronary blood flow on the basis of coronary artery disease, causing severe and long-lasting acute ischemia in the corresponding myocardium, eventually leading to myocardial ischemic necrosis.

Myocardial hypoxia: The heart is deprived of oxygen due to insufficient blood supply. The main manifestations are: palpitations, heart discomfort, sometimes heart pain or appreciation of colic; shortness of breath, exercise, fullness or agitation is more serious, the body is weak; in severe cases, short-term shock.

Myocardial abscess: Myocardial edema is one of the main clinical symptoms of dilated cardiomyopathy. Myocardial gray and relaxation is a type of myocardial damage, which may be related to immune myocardial damage after viral infection, and is generally seen in ultrasonography of dilated cardiomyopathy. Can be used as a differential diagnosis with other cardiomyopathy.

Cardiac hypertrophy: This is a slower but more effective compensatory function, mainly in the case of long-term stress overload, increased myocardial volume, increased contractility, allowing the heart to maintain a normal blood circulation, and at the same time Reserve power. However, this compensatory function also has its disadvantages, mainly because of hypertrophic myocardial aerobic increase, and the coronary blood supply is often unable to be met, resulting in myocardial ischemia, which will eventually lead to a decline in myocardial contractility. Hypertrophic cardiomyopathy is characterized by cardiac hypertrophy. It is characterized by ventricular muscle hypertrophy, typically in the left ventricle, with interventricular septum, occasionally concentric hypertrophy.

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