被致心律失常性右心室发育不良/心肌病掩盖的心脏结节病
Cardiac sarcoidosis concealed by arrhythmogenic right ventricular dysplasia/cardiomyopathy.
作者信息
Greif Martin, Petrakopoulou Paraskevi, Weiss Max, Reithmann Christopher, Reichart Bruno, Nabauer Michael, Steinbeck Gerhard
机构信息
Department of Cardiology, University Hospital of Munich, Munich, Germany.
出版信息
Nat Clin Pract Cardiovasc Med. 2008 Apr;5(4):231-6. doi: 10.1038/ncpcardio1146.
BACKGROUND
A 37-year-old male with a history of palpitations and ventricular tachycardia was diagnosed with arrhythmogenic right ventricular dysplasia/cardiomyopathy on the basis of clinical assessment, electrocardiography and echocardiography. Over the following 3 years the patient progressed to end-stage heart failure and eventually underwent heart transplantation. Histological analysis of the explanted heart revealed the presence of numerous noncaseating granulomas.
INVESTIGATIONS
Electrocardiography, echocardiography, 24 h Holter monitoring, cardiac MRI, coronary angiography, endomyocardial biopsy, exercise testing, electrophysiological study, laboratory examinations and histological examination of the explanted heart.
DIAGNOSIS
Cardiac sarcoidosis.
MANAGEMENT
Immunosupressive and corticosteroid therapy. Routine endomyocardial biopsy is planned.
背景
一名37岁男性，有心悸和室性心动过速病史，根据临床评估、心电图和超声心动图诊断为致心律失常性右室发育不良/心肌病。在接下来的3年里，该患者进展为终末期心力衰竭，最终接受了心脏移植。移植心脏的组织学分析显示存在大量非干酪样肉芽肿。
检查
心电图、超声心动图、24小时动态心电图监测、心脏磁共振成像、冠状动脉造影、心内膜活检、运动试验、电生理研究、实验室检查以及移植心脏的组织学检查。
诊断
心脏结节病。
治疗
免疫抑制和皮质类固醇治疗。计划进行常规心内膜活检。
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