Awasthy N, Tomar M, Radhakrishnan S
Department of Congenital and Pediatric Heart disease, Fortis Escorts Heart Institute, New Delhi, 110025.
Images Paediatr Cardiol. 2012 Jan;14(1):1-5.
Biventricular noncompaction is a recently recognized rare form of cardiomyopathy. It is characterized by altered structure of myocardial wall as a result of intrauterine arrest of compaction of the myocardial fibers in absence of coexisting congenital lesion. Left ventricle is the most affected site for noncompaction, but right ventricular involvement has been reported in a few cases. Diagnosis is made with 2-dimensional echocardiography or cardiac magnetic resonance imaging. While major clinical manifestations are heart failure, arrhythmias and embolic events,pulmonary artery hypertension (PAH) has not been well elaborated in the literature. We present a 13-year old boy who had Biventricular noncompaction complicated by severe pulmonary hypertension. Pulmonary hypertension may be a consequence of increased pulmonary venous pressures caused by systolic and diastolic left ventricular dysfunction secondary to noncompaction. We review the literature particularly with reference toPAH in the context of our case.
双心室心肌致密化不全是一种最近才被认识到的罕见心肌病形式。其特征是由于在无并存先天性病变的情况下心肌纤维致密化在子宫内停滞,导致心肌壁结构改变。左心室是心肌致密化不全最常受累的部位,但少数病例也有右心室受累的报道。诊断依靠二维超声心动图或心脏磁共振成像。虽然主要临床表现为心力衰竭、心律失常和栓塞事件,但肺动脉高压(PAH)在文献中尚未得到充分阐述。我们报告一名13岁男孩,患有双心室心肌致密化不全并伴有严重肺动脉高压。肺动脉高压可能是由于心肌致密化不全继发的左心室收缩和舒张功能障碍导致肺静脉压力升高的结果。我们结合病例对相关文献进行综述,尤其关注PAH。