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女性二尖瓣脱垂患者因心室颤动导致心搏骤停。

Aborted sudden cardiac death due to ventricular fibrillation in a female patient with mitral valve prolapse.

机构信息

Department of Cardiology, Angiology and Sleep Medicine, Bonifatius Hospital Lingen, Wilhelmstrasse 13, 49808, Lingen, Germany.

出版信息

Cardiovasc Ultrasound. 2021 Jan 27;19(1):10. doi: 10.1186/s12947-020-00236-9.

Abstract

BACKGROUND

Mitral valve prolapse is the most frequent valvular defect associated with a wide range of electro-hemodynamic abnormalities, leading to heart failure, arrhythmias and sudden cardiac death. Mitral valve prolapse, first described from Barlow in the 1960s, is defined as displacement of mitral leaflet tissue into the left atrium past the mitral annular plane during systole. The correlation between mitral valve prolapse and sudden cardiac death has been investigated and clarified by various studies in recent years. However, identifying patients at risk and applying measures to prevent those from sudden cardiac death is challenging.

CASE PRESENTATION

We report on a 61-year-old female patient who had undergone an aborted sudden cardiac death. An arrythmogenic mitral valve prolapse was diagnosed. In addition, electrocardiographically and morphologically risk markers for sudden cardiac death were found in this case. We performed an ICD implantation as secondary prophylaxis and intended to reconstruct the mitral valve.

CONCLUSION

This article examines the association of mitral valve prolapse with sudden cardiac death, the underlying pathophysiological mechanisms and the strategies leading to identify the risk group.

摘要

背景

二尖瓣脱垂是最常见的瓣膜缺陷,与广泛的电-血液动力学异常相关,导致心力衰竭、心律失常和心源性猝死。二尖瓣脱垂由 Barlow 于 20 世纪 60 年代首次描述,定义为收缩期二尖瓣瓣叶组织移位至二尖瓣环平面以下进入左心房。近年来,多项研究调查并阐明了二尖瓣脱垂与心源性猝死之间的相关性。然而,确定高危患者并采取措施预防心源性猝死仍然具有挑战性。

病例报告

我们报告了一例 61 岁女性患者,该患者曾发生过心源性猝死未遂。诊断为致心律失常性二尖瓣脱垂。此外,该病例还发现了心电图和形态学上的致心源性猝死风险标志物。我们进行了 ICD 植入作为二级预防,并计划重建二尖瓣。

结论

本文研究了二尖瓣脱垂与心源性猝死之间的关联,潜在的病理生理机制以及识别风险群体的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a85/7842027/927f772ba01a/12947_2020_236_Fig1_HTML.jpg

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