Diestro Jose Danilo Bengzon, Regaldo Joseph Justin Hipolito, Gonzales Eddieson Masangcay, Dorotan Maria Kristina Casanova, Espiritu Adrian Isidro, Pascual Jose Leonard Rivera
Department of Neurosciences, Philippine General Hospital, University of the Philippines, Manila, Philippines.
Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
BMJ Case Rep. 2017 Aug 8;2017:bcr-2017-219763. doi: 10.1136/bcr-2017-219763.
Cor triatriatum sinistrum (CTS) is a congenital anomaly where the left atrium is divided into two compartments by a fibromuscular membrane. This report aims to add to the literature on a rare cardiac condition that can cause neurological morbidity. We report a case of a 19-year-old female with an infarct in the right middle cerebral artery (MCA) territory initially maintained on aspirin. Eighteen months later, she had recurrence of weakness, for which repeat transthoracic echocardiography (TTE) and re-evaluation of the first TTE demonstrated a hyperechoic membrane spanning the width of the left atrium, clinching the diagnosis of CTS. Despite anticoagulation with apixaban, she was admitted for a third stroke where she succumbed to hospital-acquired pneumonia. Among cases of CTS associated with stroke, anticoagulation and surgery were the main modes of treatment. This case has the longest follow-up and the first to demonstrate failure of antiplatelet therapy and anticoagulation.
左心房三房心（CTS）是一种先天性异常，其中左心房被一层纤维肌膜分为两个腔室。本报告旨在补充关于一种可导致神经功能障碍的罕见心脏疾病的文献。我们报告一例19岁女性，最初因右侧大脑中动脉（MCA）区域梗死而服用阿司匹林治疗。18个月后，她出现肌无力复发，再次行经胸超声心动图（TTE）检查及对首次TTE检查结果进行重新评估时，发现左心房宽度处有一高回声膜，确诊为CTS。尽管使用阿哌沙班进行抗凝治疗，但她因第三次中风入院，最终死于医院获得性肺炎。在与中风相关的CTS病例中，抗凝和手术是主要治疗方式。该病例随访时间最长，且首次证明抗血小板治疗和抗凝治疗无效。
