Pizoń Tomasz, Rajzer Marek, Wojciechowska Wiktoria, Jastrzebski Marek, Olszanecka Agnieszka, Rojek Marta, Jurczyszyn Artur, Czarnecka Danuta
Przegl Lek. 2015;72(5):271-5.
A 76-year old woman with a history of stage 3 arterial hypertension, paroxysmal atrial fibrillation, hypercholesterolemia and type 2 diabetes mellitus. Ventricular tachycardia was the first clinical manifestation of the disease. Echocardiography revealed hypertrophic cardiomyopathy with a high intraventricular gradient of 47 mmHg and midventricular obstruction at the level of the papillary muscles (the lumen of the left ventricle was 1-2 mm during systole). No ventricular aneurysm was found but the ventricle was elongated and dilated in the periapical part where systolic function was decreased but synchronized in time. Coronary angiograms showed no narrowing of coronary arteries. A single-chamber cardioverter-defibrillator (ICD, implantable cardioverter-defibrillator) was implanted to prevent sudden cardiac death. Modified-release metoprolol and amiodarone were administered in antiarrhythmic therapy. This case represents a rare kind of hypertrophic cardiomyopathy in an elderly woman which is characterized by midventricular obstruction.
一名76岁女性，有3期动脉高血压、阵发性心房颤动、高胆固醇血症和2型糖尿病病史。室性心动过速是该疾病的首发临床表现。超声心动图显示肥厚型心肌病，室内压差高达47 mmHg，乳头肌水平存在室中隔梗阻（收缩期左心室腔为1 - 2 mm）。未发现室壁瘤，但心室在根尖部拉长、扩张，此处收缩功能降低但时间上同步。冠状动脉造影显示冠状动脉无狭窄。植入了单腔心脏复律除颤器（ICD，植入式心脏复律除颤器）以预防心脏性猝死。抗心律失常治疗中使用了缓释美托洛尔和胺碘酮。该病例代表了老年女性中一种罕见的肥厚型心肌病，其特征为室中隔梗阻。
