经超声心动图诊断的右侧心内膜炎罕见定位：一例报告
A rare localization in right-sided endocarditis diagnosed by echocardiography: a case report.
作者信息
Cosson Stéphane, Kevorkian Jean-Philippe, Milliez Paul, Beaufils Philippe, Cohen Ariel
机构信息
Service de Cardiologie, Hôpital Lariboisière, Paris, France.
出版信息
Cardiovasc Ultrasound. 2003 Aug 14;1:10. doi: 10.1186/1476-7120-1-10.
BACKGROUND
Right-sided endocarditis occurs predominantly in intravenous drug users, patients with pacemakers or central venous lines and with congenital heart diseases. The vast majority of cases involve the tricuspid valve.
CASE PRESENTATION
A case of a 31-year-old woman with intravenous drug abuse who had a right-sided vegetation attached to the muscular bundle of the right ventricle is presented. Transthoracic echocardiography revealed a vegetation in the right ventricular outflow tract. Transesophageal echocardiography clearly showed that the 1.8 cm vegetation was not adherent to the pulmonary valve but attached to a muscular bundle.
CONCLUSIONS
Our case points to an unusual location of right-sided endocarditis in intravenous drug users. It confirms that TTE remains an easy and highly sensitive first-line examination for the diagnosis of right-sided endocarditis.
背景
右侧心内膜炎主要发生在静脉吸毒者、有起搏器或中心静脉导管的患者以及患有先天性心脏病的患者中。绝大多数病例累及三尖瓣。
病例报告
本文报告一例31岁静脉吸毒女性患者，其右侧心室肌束上附着有赘生物。经胸超声心动图显示右心室流出道有一赘生物。经食管超声心动图清楚地显示，1.8厘米的赘生物未附着于肺动脉瓣，而是附着于一束肌肉上。
结论
我们的病例指出了静脉吸毒者右侧心内膜炎的一个不寻常部位。这证实了经胸超声心动图仍然是诊断右侧心内膜炎的一种简便且高度敏感的一线检查方法。
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