Seraphim Andreas, Papachristidis Alexandros, Bratt Naomi, Shiu Man Fai
Department of Cardiology, Royal Free Hospital, London, UK.
J Cardiol Cases. 2014 Jan 15;9(4):138-142. doi: 10.1016/j.jccase.2013.12.006. eCollection 2014 Apr.
We describe the case of a 48-year-old patient who presented with an out-of-hospital cardiac arrest due to an acute ST-elevation myocardial infarction. Left ventriculography performed during the initial coronary angiography revealed the presence of structural abnormalities in the myocardial wall which subsequently, with the use of contrast echocardiography and cardiac magnetic resonance imaging, were confirmed to represent ventricular clefts. We reviewed the pathophysiological significance of these defects and compared them with similarly looking abnormalities such as aneurysms, pseudoaneurysms, and diverticula. In conclusion, recognition of ventricular clefts is needed to allow clinicians to differentiate them from other myocardial wall defects with different pathological profile and clinical significance. With emerging techniques in cardiac imaging some cardiac abnormalities such as left ventricular (LV) clefts are recognized more frequently. This case report describes an incidental finding of LV cleft and provides an extensive review of the literature regarding the clinical significance and differential from other similar findings of different pathology. That will help physicians to distinguish these overlapping findings and tailor patients' management accordingly.>.
我们描述了一名48岁患者的病例,该患者因急性ST段抬高型心肌梗死出现院外心脏骤停。在初次冠状动脉造影期间进行的左心室造影显示心肌壁存在结构异常,随后通过对比超声心动图和心脏磁共振成像证实这些异常为心室壁裂。我们回顾了这些缺损的病理生理意义,并将它们与外观相似的异常情况(如动脉瘤、假性动脉瘤和憩室)进行了比较。总之,需要认识到心室壁裂,以便临床医生将它们与具有不同病理特征和临床意义的其他心肌壁缺损区分开来。随着心脏成像技术的不断发展,一些心脏异常情况(如左心室壁裂)的发现越来越频繁。本病例报告描述了偶然发现的左心室壁裂,并对有关其临床意义以及与其他不同病理的类似发现的鉴别诊断的文献进行了广泛回顾。这将有助于医生区分这些重叠的发现,并据此调整患者的治疗方案。