Sherrid Mark V, Balaran Sandhya K, Korzeniecki Eva, Chaudhry Farooq A, Swistel Daniel G
Echocardiography Laboratory and Hypertrophic Cardiomyopathy Program, St. Luke's-Roosevelt Hospital Center, Columbia University, College of Physicians and Surgeons, New York, New York 10019, USA.
Echocardiography. 2011 Oct;28(9):E174-9. doi: 10.1111/j.1540-8175.2011.01459.x. Epub 2011 Jul 31.
A 70-year-old male with known hypertrophic cardiomyopathy (HCM) and latent obstruction presented with new onset of cardiogenic shock. He had a new resting left ventricular (LV) outflow gradient of 90 mmHg, and new severe LV systolic dysfunction. Because of rapid deterioration despite medical management he was urgently sent for surgical relief of obstruction, which immediately reversed both the LV dysfunction and shock. A second patient, a 58-year-old male also with hypertrophic cardiomyopathy and latent obstruction presented with collapse, cardiogenic shock, 135 mmHg resting LV outflow gradient and new severe LV systolic dysfunction. His profound shock was irreversible with pharmacologic management, but surgical relief of obstruction reversed both his LV dysfunction and shock. Echocardiography plays a pivotal role in the management of these acutely ill patients.
一名70岁男性，已知患有肥厚型心肌病（HCM）且存在潜在梗阻，现出现新发的心源性休克。他静息时左心室（LV）流出道压差新增至90 mmHg，同时出现新的严重左心室收缩功能障碍。尽管进行了药物治疗，但病情仍迅速恶化，因此他被紧急送往医院进行梗阻解除手术，术后左心室功能障碍和休克立即得到缓解。另一名患者是一名58岁男性，同样患有肥厚型心肌病且存在潜在梗阻，出现了晕厥、心源性休克，静息时左心室流出道压差为135 mmHg，同时伴有新的严重左心室收缩功能障碍。药物治疗无法逆转他严重的休克状态，但梗阻解除手术使他的左心室功能障碍和休克均得到逆转。超声心动图在这些危重症患者的管理中起着关键作用。
