Hsieh Bill P C, Tauras James, Taub Cynthia
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Echocardiography. 2012 Jul;29(6):E131-3. doi: 10.1111/j.1540-8175.2011.01637.x. Epub 2012 Feb 13.
A 42-year-old female presented with chest pain, noted to have systolic and diastolic murmurs on physical examination and left ventricular hypertrophy on the electrocardiogram. Echocardiography with contrast enhancement revealed hypertrophic cardiomyopathy (HCM) with apical aneurysm and mid left ventricular cavity obstruction. Doppler interrogation showed continuous systolic and diastolic flow from the apex to left ventricle (LV) with a transient deceleration giving rise to a notched pattern. Myocardial ischemia of the apex was demonstrated on adenosine nuclear scintigraphy without epicardial coronary obstruction on angiography. This case demonstrates a novel Doppler pattern with continuous apex to LV flow in HCM in the setting of apical ischemia that may account for the formation of the aneurysm.
一名42岁女性因胸痛就诊，体格检查发现有收缩期和舒张期杂音，心电图显示左心室肥厚。经对比增强的超声心动图显示肥厚型心肌病（HCM）伴心尖部室壁瘤及左心室中部腔室梗阻。多普勒检查显示从心尖到左心室（LV）有持续的收缩期和舒张期血流，伴有短暂减速，形成切迹样图形。腺苷核素心肌显像显示心尖部心肌缺血，血管造影显示无冠状动脉阻塞。该病例展示了肥厚型心肌病心尖部缺血情况下一种新的多普勒图形，即从心尖到左心室的持续血流，这可能解释了室壁瘤的形成。
