Barik Ramachandra, Akula Siva Prasad, Damera Sheshagiri Rao
Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
J Cardiovasc Echogr. 2016 Apr-Jun;26(2):56-60. doi: 10.4103/2211-4122.183758.
We report a case illustrating a 39-year-old man with delayed presentation of severe pulmonary valve (PV) stenosis, clinical evidence of congestive right heart failure in the form of enlarged liver, raised jugular venous pressure, and anasarca without cyanosis. Echocardiography (echo) was used both for diagnosis and monitoring this patient as main tool. The contractile reserve of the right ventricle (RV) was evaluated by infusion of dobutamine and diuretic for 4 days before pulmonary balloon valvotomy. Both the tricuspid annular peak systolic excursion and diastolic (diastolic anterograde flow through PV) function of RV improved after percutaneous balloon pulmonary valvotomy. These improvements were clinically apparent by complete resolution of anasarca, pericardial effusion, and normalization albumin-globulin ratio. The periprocedural echo findings were quite unique in this illustration.
我们报告一例病例，该病例为一名39岁男性，严重肺动脉瓣狭窄出现延迟，有充血性右心衰竭的临床证据，表现为肝脏肿大、颈静脉压升高和全身性水肿但无发绀。超声心动图（echo）作为主要工具用于该患者的诊断和监测。在进行肺动脉球囊瓣膜切开术前4天，通过静脉输注多巴酚丁胺和利尿剂评估右心室（RV）的收缩储备。经皮肺动脉球囊瓣膜切开术后，三尖瓣环收缩期峰值位移和右心室舒张期（舒张期通过肺动脉瓣的正向血流）功能均得到改善。全身性水肿、心包积液完全消退以及白蛋白 - 球蛋白比值恢复正常，这些改善在临床上很明显。在本病例中，围手术期的超声心动图表现相当独特。
