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一名肺鳞状细胞癌患者出现严重的心功能不全,类似于由心肌转移引起的伴有左束支传导阻滞的扩张型心肌病。

A patient with lung squamous cell carcinoma presenting with severe cardiac dysfunction similar to dilated cardiomyopathy with left bundle branch block induced by myocardial metastasis.

作者信息

Ogino Hirokazu, Nishimura Naoki, Kitamura Atsushi, Ishikawa Genta, Okafuji Kohei, Tomishima Yutaka, Jinta Torahiko, Yamazoe Masahiro, Yang Yang, Chohnabayashi Naohiko

机构信息

Division of Pulmonary Medicine, St. Luke's Internal Hospital, Japan.

出版信息

Intern Med. 2014;53(20):2353-7. doi: 10.2169/internalmedicine.53.2616. Epub 2014 Oct 15.

Abstract

A patient with severe cardiac dysfunction similar to dilated cardiomyopathy expired because of lung squamous cell carcinoma. He was admitted with respiratory failure and was diagnosed with congestive heart failure due to dilated cardiomyopathy based on the chest X-ray, electrocardiography, echocardiography, and coronary angiography. Chest computed tomography showed a mass shadow in the right lower lobe, and the patient was diagnosed with lung squamous cell carcinoma by bronchoscopy. The patient expired, and the autopsy revealed that a myocardial metastasis disrupted the cardiac-conduction system without dilated cardiomyopathy in myocytes. Left bundle branch block caused by myocardial metastasis presumably induced left cardiac dysfunction.

摘要

一名患有类似于扩张型心肌病的严重心脏功能障碍的患者因肺鳞状细胞癌死亡。他因呼吸衰竭入院,根据胸部X光、心电图、超声心动图和冠状动脉造影被诊断为扩张型心肌病所致的充血性心力衰竭。胸部计算机断层扫描显示右下叶有肿块阴影,患者通过支气管镜检查被诊断为肺鳞状细胞癌。患者死亡,尸检显示心肌转移破坏了心脏传导系统,心肌细胞中无扩张型心肌病。心肌转移引起的左束支传导阻滞可能导致了左心功能障碍。

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