Ortiz de Murua José Antonio, de la Fuente Blanco Laura, Trigo-Bautista Alberto, Ruiz-Olgado María José
Complejo Asistencial de Zamora. Hospital Virgen de la Concha. Servicio de Medicina Interna. Sección de Cardiología, Av. Requejo n 6. Zamora, Spain.
Eur Heart J Case Rep. 2021 Jul 1;5(7):ytaa499. doi: 10.1093/ehjcr/ytaa499. eCollection 2021 Jul.
We discuss an unusual association: double atrial septum, pulmonary artery aneurysm, and severe regurgitation of multiple valves.
A 70-year-old man was admitted into the hospital because of progressive dyspnoea. Physical examination showed a blood pressure of 132/70 mmHg, a systolic murmur on the right upper sternal border, another systolic murmur at the apex, and a diastolic murmur at the lower left sternal border. Electrocardiogram revealed atrial fibrillation and complete left bundle branch block. Transthoracic echocardiography showed mitral prolapse, severe mitral, aortic, and pulmonary regurgitation, a 60 mm diameter pulmonary artery aneurysm, mild to moderate tricuspid regurgitation, and moderate pulmonary hypertension. Transoesophageal echocardiography also showed an unusual atrial communication consisting of a double atrial septum with a mid-line chamber between both atria. A cardiac magnetic resonance scan was performed and confirmed echocardiography findings and Q:Q ratio = 1.3.
In our knowledge, this is the first case report with this association. We present the main clinical features of the double atrial septum with persistent interatrial space, its echocardiography anatomy, differential diagnosis, and embryology.
我们讨论一种不寻常的关联：双房间隔、肺动脉瘤和多个瓣膜的严重反流。
一名70岁男性因进行性呼吸困难入院。体格检查显示血压为132/70 mmHg，右上胸骨缘有收缩期杂音，心尖处有另一收缩期杂音，左下胸骨缘有舒张期杂音。心电图显示心房颤动和完全性左束支传导阻滞。经胸超声心动图显示二尖瓣脱垂、严重二尖瓣、主动脉瓣和肺动脉瓣反流、直径60 mm的肺动脉瘤、轻度至中度三尖瓣反流和中度肺动脉高压。经食管超声心动图还显示一种不寻常的心房交通，由双房间隔组成，两心房之间有一个中线腔。进行了心脏磁共振扫描，证实了超声心动图的结果，Q:Q比值 = 1.3。
据我们所知，这是首例有这种关联的病例报告。我们介绍了伴有持续心房间隙的双房间隔的主要临床特征、其超声心动图解剖结构、鉴别诊断和胚胎学。
