Dumont C R, Varela S, Núñez A R, Rentería V, Mispireta J, Aguilar R, Kuri J
Arch Inst Cardiol Mex. 1975 May-Jun;45(3):362-73.
The case of a six year old girl with a congenital aortic stenosis is presented. A few months before being admitted to the Instituto Nacional de Cardiologia; her clinical manifestations suggested a bacterial endocarditis. The existance of an aneurismatic area in the ascending aorta and the later development of a crisis of angor pectoris, suggested a mycotic aneurism of the ascending aorta as a possible diagnosis; and the dissection or migration of septic material to the aneurism was found, it has a sacular form of 3.5 by 3.8 cm in the ascending aorta. There was also dissection into the left coronary artery at the ostium level. Microscopic study showed areas of recent myocardial necrosis on the free wall of the left ventricle and in the lower part of the interventricular septum. The etiopathogeny, clinical manifesations, radiology, evolution and treatment of mycotic aneurism were considered. The need of an early clinical diagnosis and early medical and surgical treatment is emphasized.
本文介绍了一名患有先天性主动脉瓣狭窄的六岁女孩的病例。在被国立心脏病学研究所收治前几个月,她的临床表现提示患有细菌性心内膜炎。升主动脉存在动脉瘤区域,且随后出现了心绞痛发作,提示升主动脉霉菌性动脉瘤可能是诊断结果;发现有感染性物质剥离或迁移至动脉瘤,其在升主动脉呈囊状,大小为3.5×3.8厘米。在左冠状动脉开口处也有剥离。显微镜检查显示左心室游离壁和室间隔下部有近期心肌坏死区域。文中考虑了霉菌性动脉瘤的病因、临床表现、放射学、病情发展及治疗。强调了早期临床诊断以及早期药物和手术治疗的必要性。