独歩来院にもかかわらず治療に難渋した右室梗塞の一例

Abstract

A 76-year-old man was admitted with the complaint of prolonged chest oppressive sensation. Initially, his condition was evaluated as mild because of his coming to the hospital on foot. Coronary arteriography on admission revealed total occlusion of the right coronary artery orifice and a normal left coronary system. Recanalization could not be accomplished by PTCR or PTCA. After admission, blood pressure decreased gradually and profound shock stage persisted. Right ventricular infarction was diagnosed and volume expansion therapy with use of large amounts of catecholamine was initiated. In spite of these treatments, shock stage persisted. On the 6th day, hemodynamic findings were recovering and clinical conditions were also improved. Subsequently, the patient spent a smooth clinical course and was discharged.