Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL.
College of Medicine, and the College of Pharmacy, University of Florida, Gainesville, FL.
Chest. 2016 Jun;149(6):e195-9. doi: 10.1016/j.chest.2015.12.037.
A 61-year-old man presented with an 18-month history of progressive shortness of breath on exertion, fatigue, worsening bilateral lower extremity edema, abdominal swelling, and increased assistance with activities of daily living. Pertinent past medical history included right-sided pneumonia secondary to Streptococcus pneumoniae that was complicated by empyema, requiring right-sided video-assisted thoracoscopic surgery with decortication 2 years earlier. He had a negative cardiac history, no recent travel in the last 3 years, and no known exposure to tuberculosis. His medications included aspirin and daily furosemide. His symptoms appeared to be refractory to diuretic therapy. Previous workup 6 months earlier included an echocardiography (ECHO) showing enlarged left and right atria with a normal ejection fraction, and a catheterization of the left side of the heart with reported normal left ventricular function and unobstructed coronary arteries.
一位 61 岁男性，因进行性呼吸困难、疲劳、双侧下肢水肿加重、腹部肿胀以及日常活动自理能力下降，就诊 18 个月。既往病史包括 2 年前因肺炎链球菌引起右侧脓胸，行右侧电视辅助胸腔镜手术去皮质术。患者无心脏病史，近 3 年内无旅行史，也无结核病接触史。目前服用阿司匹林和呋塞米。患者的症状似乎对利尿剂治疗无反应。6 个月前的检查包括超声心动图（ECHO）显示左右心房扩大，射血分数正常，以及左侧心导管检查显示左心室功能正常，冠状动脉无阻塞。
