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心肌膜炎后解剖性心室假性动脉瘤——病例报告

Dissecting ventricular pseudoaneurysm after perimyocarditis-a case report.

作者信息

Lindblom Rickard P F, Alström Ulrica, Zemgulis Vitas

机构信息

Department of Cardiothoracic Surgery and Anesthesia, Uppsala University Hospital, 751 85, Uppsala, Sweden.

出版信息

J Cardiothorac Surg. 2015 Nov 6;10:157. doi: 10.1186/s13019-015-0373-z.

Abstract

BACKGROUND

The current case describes the fast development of a pseudoaneurysm in a patient that presented with signs of systemic inflammation and generally deranged blood work.

CASE PRESENTATION

The pseudoaneurysm appeared within one week of disease onset. The anatomic extent of the pseudoaneurysm was unusual, as it dissected intramurally beneath the septum, inferior to the right ventricle and had effect on the RV filling. The etiology could not be definitely defined, since in adults the most common cause for pseudoaneurysm development is recent myocardial infarction, but in this patient the coronary arteries were healthy. Instead it could have been a consequence of an aggressive perimyocarditis.

CONCLUSIONS

Due to the unpredictable nature of pseudoaneurysms we advocate early contact with a center with cardiothoracic surgery expertise for rapid surgical intervention.

摘要

背景

本病例描述了一名出现全身炎症体征且血液检查结果普遍异常的患者假性动脉瘤的快速发展情况。

病例介绍

假性动脉瘤在疾病发作后一周内出现。假性动脉瘤的解剖范围不寻常,它在室间隔下方的心肌壁内进行剥离,位于右心室下方并影响右心室充盈。病因无法明确界定,因为在成年人中,假性动脉瘤形成的最常见原因是近期心肌梗死,但该患者的冠状动脉是健康的。相反,它可能是侵袭性心包炎的结果。

结论

由于假性动脉瘤的性质不可预测,我们主张尽早联系具备心胸外科专业知识的中心,以便进行快速手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e102/4636832/ed59ef665e82/13019_2015_373_Fig1_HTML.jpg

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