Abdelsalam Mahmoud A, Geske Jeffrey B
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Heart. 2017 Feb 15;103(4):315. doi: 10.1136/heartjnl-2016-310250. Epub 2016 Sep 23.
A 77-year-old female was referred for evaluation of an episode of syncope while eating breakfast. There was no history of fall, syncope, prodrome, dyspnoea, chest discomfort or palpitations. Medical history was notable for hyperlipidaemia and treated hypertension. Blood pressure was 140/90 mm Hg, pulse 85 beats per minute (BPM). No murmurs were present on cardiac examination. ECG revealed normal sinus rhythm with left ventricular (LV) hypertrophy (see online supplementary figure S1). Holter monitor demonstrated rare premature ventricular complexes (<1% of beats), without heart block or ventricular tachycardia. Transthoracic echocardiogram is shown in figure 1.
Which of the following is the explanation for the flow indicated by the yellow arrow? Aortic stenosisCoronary artery flow, indicative of coronary fistulaHypertrophic cardiomyopathy with apical pouchHypertensive heart diseaseMitral stenosis.
一名77岁女性因早餐时发生晕厥前来接受评估。既往无跌倒、晕厥、前驱症状、呼吸困难、胸部不适或心悸病史。病史以高脂血症和已治疗的高血压为显著特点。血压为140/90 mmHg，脉搏85次/分钟。心脏检查未闻及杂音。心电图显示正常窦性心律伴左心室肥厚（见在线补充图S1）。动态心电图监测显示罕见室性早搏（<1%的心搏），无心脏传导阻滞或室性心动过速。经胸超声心动图见图1。
以下哪项是黄色箭头所示血流的解释？主动脉瓣狭窄；冠状动脉血流，提示冠状动脉瘘；伴有心尖部袋状结构的肥厚型心肌病；高血压性心脏病；二尖瓣狭窄。
