Picard R, Picard C, Batisse J P, Touche T
Service de médecine légale, hôpital Villemin, Nancy.
Arch Mal Coeur Vaiss. 1990 Aug;83(9):1459-62.
The authors report the case of a child followed up from the age of 4 months to the age of 15 for asymptomatic congenital heart disease. Initial clinical examination showed the presence of a systolic murmur and a diastolic rumble in the xiphoid area with signs of right atrial dilatation-hypertrophy. During follow-up, an apical diastolic rumble was detected with left atrial dilatation from the age of 3. Doppler echocardiography carried out recently showed double mitral and tricuspid valve stenosis with two-dimensional appearances of doming of both valves and moderate transvalvular pressure gradients with slight elevation of pulmonary artery pressures on the Doppler study. The very early detection of the malformation and the continuous follow-up of this patient indicate the congenital and not rheumatic origin of this double valve stenosis.
作者报告了一名从4个月大至15岁因无症状先天性心脏病接受随访的儿童病例。初始临床检查显示剑突下区域存在收缩期杂音和舒张期隆隆样杂音，伴有右心房扩张-肥厚体征。随访期间，3岁起检测到心尖部舒张期隆隆样杂音及左心房扩张。近期进行的多普勒超声心动图显示二尖瓣和三尖瓣双瓣狭窄，二维表现为两个瓣膜的圆顶状，多普勒研究显示跨瓣压力梯度适中，肺动脉压力略有升高。该畸形的早期发现及对该患者的持续随访表明这种双瓣狭窄的病因是先天性而非风湿性。
