Sathananthan Janarthanan, Gabriel Ruvin, Kay Patrick, Van Pelt Niels
Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.
Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.
Heart Lung Circ. 2014 Jun;23(6):586-8. doi: 10.1016/j.hlc.2013.11.011. Epub 2013 Dec 3.
We present the case of a 26 year-old man who presented to hospital with monomorphic ventricular tachycardia (VT) at a rate of 170bpm after exercising on a treadmill. Multimodality imaging with transthoracic echocardiogram (TTE), cardiac magnetic resonance imaging (CMRI) and computed tomography coronary angiogram (CTCA) demonstrated two causes for ventricular tachycardia; hypertrophic cardiomyopathy (HCM) and an anomalous right coronary artery (RCA) arising from the left coronary sinus, with a potentially malignant interarterial course. Both conditions can be associated with sudden cardiac death (SCD). We discuss the management dilemmas in this unique patient.
我们报告一例26岁男性病例，该患者在跑步机上运动后以170次/分钟的速率出现单形性室性心动过速（VT）并入院。经胸超声心动图（TTE）、心脏磁共振成像（CMRI）和计算机断层扫描冠状动脉造影（CTCA）等多模态成像显示了室性心动过速的两个病因；肥厚型心肌病（HCM）和起源于左冠状窦的异常右冠状动脉（RCA），其走行于动脉间，具有潜在恶性。这两种情况都可能与心源性猝死（SCD）相关。我们讨论了这位特殊患者的管理困境。
