Koç Mevlüt, Sahin Durmuş Yıldıray, Tekin Kamuran, Caylı Murat
Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
Turk Kardiyol Dern Ars. 2011 Oct;39(7):591-4. doi: 10.5543/tkda.2011.01534.
Peripartum cardiomyopathy is a rare cardiac disorder. Although left ventricular apical thrombus formation is common in peripartum cardiomyopathy, biventricular apical thrombi formation is a very rare condition in these patients. A 21-year-old woman presented with complaints of dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and palpitations that appeared three months after labor. Transthoracic echocardiography showed severe global hypokinesis, decreased left and right ventricular ejection fraction (left 30%, right 35%), increased left ventricular end-diastolic dimension (60 mm), grade 2 mitral regurgitation, and biventricular apical thrombi. On the second day of admission, she developed global aphasia and right hemiplegia. The patient was successfully treated with recombinant tissue plasminogen activator. Transthoracic echocardiography following treatment showed disappearance of biventricular apical thrombi. She had no neurologic deficit. Treatment for heart failure was continued due to persistence of global hypokinesis and left ventricular dilatation.
围产期心肌病是一种罕见的心脏疾病。虽然左心室心尖部血栓形成在围产期心肌病中很常见，但双心室心尖部血栓形成在这些患者中是非常罕见的情况。一名21岁女性产后三个月出现呼吸困难、端坐呼吸、阵发性夜间呼吸困难和心悸。经胸超声心动图显示严重的全心运动减弱、左心室和右心室射血分数降低（左心室30%，右心室35%）、左心室舒张末期内径增加（60mm）、二尖瓣反流2级以及双心室心尖部血栓。入院第二天，她出现了完全性失语和右侧偏瘫。该患者接受重组组织型纤溶酶原激活剂治疗成功。治疗后经胸超声心动图显示双心室心尖部血栓消失。她没有神经功能缺损。由于全心运动减弱和左心室扩张持续存在，继续进行心力衰竭治疗。
