Abdullah Hazrini, Jiyen Kam, Othman Norliza
Department of Imaging, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia.
Department of Cardiology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia.
BMJ Case Rep. 2017 Sep 27;2017:bcr-2017-221466. doi: 10.1136/bcr-2017-221466.
We present a case of a 20-year-old Malay man with underlying tuberculous (TB) lymphadenitis who presented with shortness of breath and found to have submitral left ventricular aneurysm (SLVA). SLVA is well recognised but rare. Incidence of SLVA in Malay has never been documented. This is the first reported case of SLVA in Malays with concomitant thoracic aorta mycotic aneurysm. TB has been reported to be associated with SLVA. Treatment is either surgical or conservative. Imaging is required for diagnosis and preoperative assessment. Multimodality imaging include echocardiography (ECHO), cardiac CTangiography and the robust multiparametric cardiac MR (CMR). ECHO is the first line imaging and useful for initial detection of the aneurysm. CMR including the late gadolinium enhancement allows excellent visualisation of the LV aneurysm, tissue characterisation, cardiac function and detection of associated pathology as shown in this case.
我们报告一例20岁的马来男性病例，该患者患有潜在的结核性淋巴结炎，出现呼吸急促症状，经检查发现患有二尖瓣下左心室动脉瘤（SLVA）。SLVA虽已为人熟知，但较为罕见。马来人群中SLVA的发病率尚无文献记载。这是首例报道的马来人同时患有胸主动脉霉菌性动脉瘤的SLVA病例。据报道，结核病与SLVA有关。治疗方法包括手术治疗或保守治疗。诊断和术前评估需要进行影像学检查。多模态成像包括超声心动图（ECHO）、心脏CT血管造影和强大的多参数心脏磁共振成像（CMR）。ECHO是一线成像检查，有助于初步检测动脉瘤。如本病例所示，包括钆增强延迟成像在内的CMR能够出色地显示左心室动脉瘤、进行组织特征分析、评估心脏功能并检测相关病变。
