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肥厚型心肌病伴严重左心室流出道梗阻患者的妊娠情况

Pregnancy in Hypertrophic Cardiomyopathy with Severe Left Ventricular Outflow Tract Obstruction.

作者信息

Shin Jaeouk, Kim Minsu, Lee Junsoo, Kim Sihun, Kim Myeonggun, Hwang Hyunjung, Moon Jeonggeun, Shin Mi-Seung, Chung Wook-Jin

机构信息

Department of Cardiovascular Medicine, Gachon University Gil Medical Center, Incheon, Korea.; Gachon Cardiovascular Research Institute, Gachon University, Incheon, Korea.

出版信息

J Cardiovasc Ultrasound. 2016 Jun;24(2):158-62. doi: 10.4250/jcu.2016.24.2.158. Epub 2016 Jun 22.

DOI:10.4250/jcu.2016.24.2.158
PMID:27358709
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4925394/
Abstract

Hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular outflow tract (LVOT) obstruction (those with a gradient of > 100 mm Hg) are at the highest risk of hemodynamic deterioration during pregnancy. Complications of HOCM include sudden cardiac death, heart failure, and arrhythmias. Physiological changes during pregnancy may induce these complications, affecting maternal and fetal health conditions. Therefore, close monitoring with appropriate management is essential for the well-being of both mother and fetus. We report on the case of a 27-year-old female patient with severe LVOT obstruction HOCM, pressure gradient (PG) of 125 mm Hg at resting, and 152 mm Hg induced by the Valsalva maneuver at 34 weeks gestation. This case showed how close monitoring using echocardiography and proper management during the course of pregnancy resulted in successful delivery in the patient with extremely high PG HOCM.

摘要

患有严重左心室流出道（LVOT）梗阻（压差>100 mmHg）的肥厚性梗阻性心肌病（HOCM）患者在孕期发生血流动力学恶化的风险最高。HOCM的并发症包括心源性猝死、心力衰竭和心律失常。孕期的生理变化可能诱发这些并发症，影响母婴健康状况。因此，进行密切监测并给予适当处理对于母婴的健康至关重要。我们报告一例27岁患有严重LVOT梗阻的HOCM女性患者，静息时压力阶差（PG）为125 mmHg，孕34周时瓦尔萨尔瓦动作诱发的PG为152 mmHg。该病例展示了在孕期通过超声心动图进行密切监测以及适当处理如何使PG极高的HOCM患者成功分娩。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67ab/4925394/35b8db02fac5/jcu-24-158-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67ab/4925394/e3b2cc862ab0/jcu-24-158-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67ab/4925394/8e23b1a295b9/jcu-24-158-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67ab/4925394/e901bfa13cdf/jcu-24-158-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67ab/4925394/35b8db02fac5/jcu-24-158-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67ab/4925394/e3b2cc862ab0/jcu-24-158-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67ab/4925394/8e23b1a295b9/jcu-24-158-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67ab/4925394/e901bfa13cdf/jcu-24-158-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67ab/4925394/35b8db02fac5/jcu-24-158-g004.jpg

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