Yazdan-Ashoori Payam, Jimenez-Juan Laura, Pereira Lisa, Ahmed Shaheeda
Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
CJC Open. 2020 Jul 2;2(6):702-704. doi: 10.1016/j.cjco.2020.06.017. eCollection 2020 Nov.
A 75-year-old male with a cardiopulmonary history presented with chest pain and dyspnea. He was hypertensive. An electrocardiogram showed paced rhythm. A high-sensitivity test showed his troponin T level was minimally elevated. Coronary angiography results were unremarkable. Chest radiography revealed an elevated cardiac apex, previously attributed to cardiomegaly. Echocardiography revealed a teardrop shaped heart in a nonstandard apical window. Computed tomography confirmed congenital absence of the left pericardium. Challenges of recognizing a rare condition are highlighted. Congenital absence of the pericardium, an often benign but rarely catastrophic condition, can masquerade for decades before diagnosis, underlining the importance of clinical vigilance in evaluating common cardiac complaints.
一名有心肺病史的75岁男性出现胸痛和呼吸困难。他患有高血压。心电图显示为起搏心律。高敏检测显示他的肌钙蛋白T水平略有升高。冠状动脉造影结果无异常。胸部X线检查显示心尖抬高，之前归因于心脏扩大。超声心动图显示在非标准心尖窗可见泪滴形心脏。计算机断层扫描证实先天性左心包缺如。强调了识别这种罕见病症的挑战。先天性心包缺如，一种通常为良性但极少有灾难性后果的病症，在诊断前可能隐匿数十年，突显了临床警惕性在评估常见心脏症状时的重要性。
