Chatelain Shaun, Comp Robert A, Grace R Randal, Sabbath Adam M
Tex Heart Inst J. 2015 Feb 1;42(1):63-5. doi: 10.14503/THIJ-13-3728. eCollection 2015 Feb.
A 50-year-old black man presented at the emergency department with midsternal, nonradiating chest pressure and chronic dyspnea on exertion. Four years before the current admission, he had been diagnosed with nonischemic cardiomyopathy at another facility. After our complete evaluation, we suspected that his symptoms arose from left-to-left shunting in association with pulmonary sequestration, a congenital malformation. Our preliminary diagnosis of secondary dilated cardiomyopathy was confirmed by normalization of the patient's ventricular size and function after lobectomy. To our knowledge, this patient is the oldest on record to present with cardiomyopathy consequent to pulmonary sequestration. His case is highly unusual because of his age and the rapid resolution of his symptoms after lobectomy. We believe that pulmonary sequestration should be included in the differential diagnosis of dilated cardiomyopathy.
一名50岁的黑人男性因胸骨后非放射性胸痛及慢性劳力性呼吸困难就诊于急诊科。本次入院前四年，他在另一家医疗机构被诊断为非缺血性心肌病。经过全面评估，我们怀疑他的症状源于与肺隔离症（一种先天性畸形）相关的左向左分流。患者行肺叶切除术后心室大小及功能恢复正常，证实了我们最初诊断的继发性扩张型心肌病。据我们所知，该患者是有记录以来因肺隔离症导致心肌病的年龄最大者。由于他的年龄以及肺叶切除术后症状迅速缓解，他的病例非常罕见。我们认为，肺隔离症应纳入扩张型心肌病的鉴别诊断。
