Abugroun Ashraf, Taha Mohamed, Daoud Hussein, Ibrahim Walid
Division of Geriatrics, Department of Internal Medicine, Wayne State University, Detroit, MI 48201, USA.
Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa, IA 52242, USA.
Oxf Med Case Reports. 2020 Feb 28;2020(2):omaa011. doi: 10.1093/omcr/omaa011. eCollection 2020 Feb.
Giant right atrium (RA) is a rare entity often seen during childhood due to congenital anomalies. Limited literature has reported such finding in patients with rheumatic valvular heart disease. Here we present a case of a 68-year-old female with a history of rheumatic valve disease treated with a Starr Edwards mechanical ball-in-cage mitral valve replacement and tricuspid valve annuloplasty ring procedures. The patient developed heart failure and had multiple hospital admissions over three decades for heart failure exacerbations mostly triggered by medication and dietary non-compliance. She eventually developed a giant RA that filled most of her thorax. This case demonstrates an extreme form of cardiac remodeling caused by long-term rheumatic valvular heart disease.
巨大右心房是一种罕见的情况，常见于儿童期的先天性异常。关于风湿性心脏瓣膜病患者出现这种情况的文献报道有限。在此，我们报告一例68岁女性患者，有风湿性瓣膜病病史，接受了斯塔尔·爱德华兹机械球笼式二尖瓣置换术和三尖瓣瓣环成形环手术。患者出现心力衰竭，在三十年中因心力衰竭加重多次住院，主要是由药物治疗和饮食不依从引发。她最终发展为巨大右心房，占据了大部分胸腔。该病例显示了长期风湿性心脏瓣膜病导致的一种极端形式的心脏重塑。
