Zhao Yonghui, Zhang Jiaying, Zhang Jing
Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Ann Noninvasive Electrocardiol. 2015 Sep;20(5):502-5. doi: 10.1111/anec.12234.
Isolated left ventricular (LV) apical hypoplasia is a unusual and recently recognized congenital cardiac anomaly. A 19-year-old man was found to have an abnormal ECG and cardiac murmur identified during a routine health check since joining work. His ECG revealed normal sinus rhythm, right-axis deviation, poor R wave progression, and T wave abnormalities. On physical examination, a 2/6～3/6 systolic murmur was heard at the second intercostal space along the left sternal border. Subsequent echocardiography and cardiac magnetic resonance imaging confirmed the LV apical hypoplasia. Of note, we first found that LV apical hypoplasia was accompanied by RV outflow tract obstruction due to exaggerated rightward bulging of the basal-anterior septum during systole. A close follow-up was performed for the development of heart failure, pulmonary hypertension, and potentially tachyarrhythmia.
孤立性左心室心尖发育不全是一种罕见且最近才被认识到的先天性心脏异常。一名19岁男性在参加工作后的一次常规健康检查中被发现心电图异常并伴有心脏杂音。他的心电图显示窦性心律正常、电轴右偏、R波进展不良以及T波异常。体格检查时，在左胸骨旁第二肋间可闻及2/6～3/6级收缩期杂音。随后的超声心动图和心脏磁共振成像证实了左心室心尖发育不全。值得注意的是，我们首次发现左心室心尖发育不全伴有右心室流出道梗阻，这是由于收缩期基底部前间隔向右过度膨出所致。对心力衰竭、肺动脉高压以及潜在的快速性心律失常的发生情况进行了密切随访。
