Krupauerová M, Sindelárová S, Mokrácek A, Vambera M
Kardiologické oddĕlení, Kardiocentrum, Ceské Budĕjovice.
Vnitr Lek. 2004 Aug;50(8):628-32.
Authors present a case of a 72 years old woman with an abnormally big left ventricular pseudoaneurysm as a consequence of a rupture of the left ventricular wall during myocardial infarction. Pseudoaneurysm threatens its carrier with both sudden death as a result of the rupture and a progressing heart failure. The patient mentioned has undergone an infero-lateral myocardial infarction complicated with beginning cardiogenic shock in July 2001. Based on coronarography examination which proved only peripheral stenoses in coronary bed a conservative procedure was indicated. In June 2002 the patient was admitted to a hospital for progressive dyspnoea, nonspecific chest and epigastric pain, and dyspeptic complaints. Transtoracal echocardiography examination proved a large pseudoaneurysm coming from periapical bottom wall of the left ventricle. Diagnosis was further confirmed and specified by ventriculography and the patient was indicated for surgery. Authors present a range of clinical signs of pseudoaneurysm, an approach to an examination, differential diagnostics and treatment procedure in patients with this unusual complication.
作者报告了一例72岁女性患者,因心肌梗死期间左心室壁破裂导致左心室假性动脉瘤异常增大。假性动脉瘤会使患者面临因破裂导致的猝死以及进行性心力衰竭的风险。上述患者于2001年7月发生下后壁心肌梗死,并伴有心源性休克。冠状动脉造影检查仅显示冠状动脉床的外周狭窄,因此采取了保守治疗。2002年6月,该患者因进行性呼吸困难、非特异性胸痛和上腹部疼痛以及消化不良症状入院。经胸超声心动图检查证实左心室心尖下壁有一个大的假性动脉瘤。心室造影进一步证实并明确了诊断,该患者被建议进行手术。作者介绍了假性动脉瘤的一系列临床症状、检查方法、鉴别诊断以及针对这种罕见并发症患者的治疗方法。