2026 年第 3 期 第 21 卷

急性非阻塞性心肌梗死伴心脏压塞及心脏停搏1例

A case of acute non-obstructive myocardial infarction complicated with cardiac tamponade and cardiac arrest

作者：余慧娟郭文龙宁怡萌邓敢

英文作者：Yu Huijuan Guo Wenlong Ning Yimeng Deng Gan

单位：湖南中医药大学附属省直中医医院湖南中医药高等专科学校附属第一医院（湖南省直中医医院）急诊科，株洲412000

英文单位：Department of Emergency Hunan Provincial Hospital of Traditional Chinese Medicine Affiliated to Hunan University of Chinese Medicine The First Affiliated Hospital of Hunan Traditional Chinese Medical College (Hunan Provincial Directly Affiliated Hospital of Traditional Chinese Medicine) Zhuzhou 412000 China

关键词：急性非阻塞性心肌梗死；心肌桥；心脏压塞；心脏停搏；体外膜氧合

英文关键词：Acutenon-obstructivemyocardialinfarction;Myocardialbridge;Cardiactamponade;Cardiacarrest;Extracorporealmembraneoxygenation

• 摘要：

• 急性心肌梗死是心血管急症中的常见病，通常由冠状动脉阻塞引起，但非阻塞性冠状动脉病变所致者相对罕见，易被漏诊。本文报道1例44岁女性胸痛患者，心电图显示ST段抬高，冠状动脉造影提示前降支心肌桥，未见显著狭窄。患者后续出现心脏压塞、心脏停搏等严重并发症，经心包穿刺、心肺复苏及体外膜氧合等综合抢救后好转。结合文献，我们探讨非阻塞性心肌梗死的发病机制、诊断及治疗策略，以提高临床医师对非典型心肌梗死的认知。

• Acute myocardial infarction is a common cardiovascular emergency, usually caused by coronary artery occlusion, while that induced by non-obstructive coronary artery disease is relatively rare and prone to misdiagnosis. This paper reports a case of a 44-year-old female patient with chest pain. Electrocardiogram showed ST-segment elevation, and coronary angiography indicated myocardial bridge of the anterior descending artery without significant stenosis. The patient subsequently developed severe complications such as cardiac tamponade and cardiac arrest, and improved after comprehensive rescue treatments including pericardiocentesis, cardiopulmonary resuscitation and extracorporeal membrane oxygenation. Combined with relevant literature, we discuss the pathogenesis, diagnosis and treatment strategies of acute non-obstructive myocardial infarction, aiming to improve clinicians′ awareness of atypical myocardial infarction.