[巨大类风湿结节致同时性完全性房室传导阻滞和严重二尖瓣反流：1例报告]

[Giant rheumatoid nodule causing simultaneous complete atrioventricular block and severe mitral regurgitation: a case report].

作者信息

Arakawa Kentaro, Yamazawa Mioko, Morita Yukiko, Kobayashi Izumi, Horiguchi Yoriko, Kamimura Daisuke, Shibue Ryoma, Mitomi Hiroyuki, Himeno Hideo, Nemoto Toyoji, Toma Shigeto

机构信息

Department of Cardiology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.

出版信息

J Cardiol. 2005 Aug;46(2):77-83.

PMID:16127897

Abstract

A 65-year-old female was first treated under a diagnosis of rheumatoid arthritis at the age of 62 years. Just after subcutaneous rheumatoid nodules appeared, she suddenly complained of shortness of breath and vomiting. The diagnosis was overt congestive heart failure with complete atrioventricular block and severe mitral regurgitation. She was treated with temporary pacing, and a permanent pacemaker was implanted 1 month later. She suffered recurrence of congestive heart failure and died 8 months later. Autopsy revealed a giant rheumatoid nodule located on the mitral valve and extending to the atrioventricular node. Presumedly this solitary giant nodule had induced complete atrioventricular block and severe mitral regurgitation.

摘要

一名65岁女性在62岁时首次因类风湿性关节炎接受治疗。就在皮下出现类风湿结节后不久，她突然出现呼吸急促和呕吐症状。诊断为明显的充血性心力衰竭，伴有完全性房室传导阻滞和严重二尖瓣反流。她接受了临时起搏治疗，并在1个月后植入了永久性起搏器。她充血性心力衰竭复发，8个月后死亡。尸检发现二尖瓣上有一个巨大的类风湿结节，并延伸至房室结。据推测，这个孤立的巨大结节导致了完全性房室传导阻滞和严重二尖瓣反流。