Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Heart. 2018 Jan;104(2):182. doi: 10.1136/heartjnl-2017-312068. Epub 2017 Oct 27.
CLINICAL INTRODUCTION: A 36-year-old man was referred for evaluation of an abnormal left ventricular (LV) structure found incidentally on transthoracic echocardiography (TTE) (figure 1). He had no symptoms except for mild palpitations. There was no significant medical history. Physical examination was unremarkable. ECG showed regular sinus rhythm with ST changes in lead II, III, avF and V6 (see online supplementary file 1). Cardiac magnetic resonance (CMR) (figure 1C) was performed. Treadmill exercise test did not demonstrate any electrocardiographic ischaemic changes. No arrhythmias were noted on Holter monitor. Which of the following is most likely the diagnosis?DC1SP110.1136/heartjnl-2017-312068.supp1Supplementary file 1 heartjnl;104/2/182/F1F1F1Figure 1Transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR). (A) Parasternal left ventricular longitudinal axis view of TTE; (B) colour Doppler of parasternal left ventricular longitudinal axis view of TTE; (C) left ventricular longitudinal axis view of CMR.
A: Lateral and inferolateral myocardial infarctionB: Congenital absence of pericardiumC: PseudoaneurysmD: Congenital left ventricular outpouching.
临床介绍：一名 36 岁男性因经胸超声心动图（TTE）偶然发现左心室（LV）结构异常而被转介评估（图 1）。他除了有轻微心悸外没有任何症状。无明显病史。体检无明显异常。心电图显示窦性心律规则，II、III、avF 和 V6 导联有 ST 改变（见在线补充文件 1）。进行心脏磁共振（CMR）（图 1C）。跑步机运动试验未显示任何心电图缺血改变。动态心电图监测未发现心律失常。最可能的诊断是什么？
