Okayama H, Doiuchi J, Abe K, Tamura A, Kodama K, Suetsugu M, Honda T, Joh T
Department of Cardiology, Ehime Prefectural Central Hospital.
Kokyu To Junkan. 1992 Dec;40(12):1215-9.
A 62-year-old woman was admitted our hospital because of concussion of the brain. The level of consciousness improved within several days. Cardiac examination was performed because the patient had experienced feelings of fainting since one year previously, and heart murmur also was heard. The electrocardiogram showed WPW configuration. At the same time that she complained of feelings of fainting, the electrocardiogram showed supraventricular tachycardia. The echocardiogram showed displacement of the septal tricuspid leaflet and mild tricuspid valve, regurgitation. Cardiac catheterization was performed and, using the intracardiac electrocardiogram, we confirmed atrialized right ventricle. We diagnosed this patient as having Ebstein's anomaly with WPW syndrome. The clinical manifestations of this anomaly are quite variable, depending upon the spectrum of pathology and the presence of associated malformations. It is well documented that a considerable proportion of these patients are able to survive into adult life. However, the patient who survives into the sixth decade without a sign of heart failure is extremely rare. We speculate that this patient had not developed right ventricular failure until her 60's because she had a milder form of Ebstein's anomaly and did not have any other congenital heart disease.
一名62岁女性因脑震荡入院。意识水平在数天内有所改善。因患者自一年前开始出现晕厥感且听到心脏杂音，故进行了心脏检查。心电图显示预激综合征（WPW）图形。在她诉说晕厥感的同时，心电图显示室上性心动过速。超声心动图显示三尖瓣隔叶移位及轻度三尖瓣反流。进行了心导管检查，通过心内心电图，我们证实了右心室房化。我们将该患者诊断为埃布斯坦畸形合并WPW综合征。这种畸形的临床表现差异很大，取决于病理类型及相关畸形的存在情况。有充分文献记载，相当一部分此类患者能够存活至成年。然而，活到六十多岁且无心力衰竭迹象的患者极为罕见。我们推测该患者直到60多岁才出现右心室衰竭，是因为她的埃布斯坦畸形症状较轻且没有其他先天性心脏病。
