Myadam Rahul, Grodzinsky Anna, Thompson Randall
Internal Medicine, University of Missouri Kansas City, Kansas City, USA.
Cardiovascular Disease, Saint Luke's Mid America Heart Institute, Kansas City, USA.
Cureus. 2020 Aug 11;12(8):e9677. doi: 10.7759/cureus.9677.
We report an unusual case of an elderly woman who presented to the hospital with melena of five-day duration. She has a past medical history of hypertrophic cardiomyopathy diagnosed three years before presentation. She was found to have arteriovenous malformations in the stomach and the duodenum, causing gastrointestinal bleeding. An association between hypertrophic cardiomyopathy and arteriovenous malformations in the gastrointestinal tract was felt likely. The patient was treated with beta-blocker therapy. Later, she was incidentally found to have an anomalous right coronary artery. We discussed potential medical and surgical options, and the patient chose to be treated medically. She was successfully treated with beta-blocker therapy with no further gastrointestinal bleeding. Her clinical course was uncomplicated without cardiac arrhythmia, heart failure, or sudden cardiac death.
我们报告了一例不寻常的病例，一名老年女性因持续五天的黑便入院。她有肥厚型心肌病病史，在此次就诊前三年被诊断出患有该病。她被发现胃和十二指肠存在动静脉畸形，导致胃肠道出血。肥厚型心肌病与胃肠道动静脉畸形之间可能存在关联。患者接受了β受体阻滞剂治疗。后来，她偶然被发现有右冠状动脉异常。我们讨论了潜在的药物和手术治疗方案，患者选择接受药物治疗。她通过β受体阻滞剂治疗成功治愈，未再出现胃肠道出血。她的临床过程无并发症，未发生心律失常、心力衰竭或心源性猝死。
