Chitkara Akshit, Sharma Varun Kumar, Puri Piyush, Pusapati Sneha
Internal Medicine, Sh. Moolchand Super Speciality Hospital, Karnal, IND.
Internal Medicine, Mahatama Gandhi Institute of Medical Sciences, Hisar, IND.
Cureus. 2020 Aug 29;12(8):e10113. doi: 10.7759/cureus.10113.
A 61-year-old patient presented to us with complaints of mild fever, rhinorrhea, sneezing, and dry cough. On auscultation, there was harsh vesicular breath sound with bilateral audible wheezing but no crackles. Also, a soft high-pitched early diastolic decrescendo murmur in third intercostal space on the left side, typical of aortic regurgitation (AR) was heard. History revealed that in 1976 he was diagnosed with AR and later in 1990 he was diagnosed with aortic root dilatation (AoD) with healed aortic root abscess (ARA). He had no history of infective endocarditis and has remained asymptomatic. The latest echocardiography revealed mild left ventricular hypertrophy (LVH) with Grade 1 LV diastolic dysfunction but no left ventricular (LV) wall motion abnormality. The patient was advised to take tablet losartan 20 mg OD to arrest the progression of his mild LVH and its related complications and continue with his lifestyle management and routine echocardiography. In some rare cases, AoD with healed ARA can remain asymptomatic over the course of decades. Regular follow up exams (every one to two years), with proper management, is the mainstay of management, along with the treatment of comorbid conditions.
一位61岁的患者前来就诊，主诉有低热、流涕、打喷嚏和干咳。听诊时，可闻及粗糙的肺泡呼吸音，双侧可闻及哮鸣音，但无湿啰音。此外，在左侧第三肋间可闻及柔和的高调舒张早期递减型杂音，这是典型的主动脉瓣关闭不全（AR）。病史显示，1976年他被诊断为AR，1990年又被诊断为主动脉根部扩张（AoD）伴愈合的主动脉根部脓肿（ARA）。他没有感染性心内膜炎病史，一直无症状。最新的超声心动图显示轻度左心室肥厚（LVH）伴1级左心室舒张功能障碍，但无左心室（LV）壁运动异常。建议患者服用氯沙坦片20mg每日一次，以阻止其轻度LVH的进展及其相关并发症，并继续进行生活方式管理和定期超声心动图检查。在一些罕见情况下，伴有愈合ARA的AoD在几十年中可能一直无症状。定期随访检查（每1至2年一次）并进行适当管理是主要的治疗手段，同时还要治疗合并症。
