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心肌炎合并巨大右心室血栓及广泛肺栓塞:一例报告

Myocarditis complicated by massive right ventricular thrombus and extensive pulmonary embolism: A case report.

作者信息

Jiang Xiao-Juan, Zhang Wei-Yi

机构信息

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Front Surg. 2022 Aug 16;9:924366. doi: 10.3389/fsurg.2022.924366. eCollection 2022.

Abstract

An intracardiac thrombus may develop as a consequence of myocarditis, and in rare cases, a dominantly right ventricular thrombus develops, which may impair cardiac function and even cause life-threatening cardiovascular events. We report a 24-year-old man presented with recurrent episodes of palpitation and precordial discomfort after catching a cold 2 months ago. Transthoracic echocardiography (TTE) and computed tomography pulmonary angiogram (CTPA) revealed a mass attached to the apex of the right ventricle and extensive bilateral pulmonary artery emboli. There was no indication where the thrombi originated from in this young patient without any underlying disease except myocarditis. Pulmonary endarterectomy and embolectomy of pulmonary arteries and right ventricle were performed. Postoperative pathological results confirmed the presence of fibrinous necrosis and hemosiderin deposition. The formation of an intraventricular thrombus is closely related to myocarditis, which can affect individuals of all ages, but especially young people. Thus, patients with myocarditis should be closely monitored and followed up because of the increased risk of extensive thrombosis.

摘要

心内血栓可能是心肌炎的结果,在罕见情况下,会形成以右心室为主的血栓,这可能损害心脏功能,甚至导致危及生命的心血管事件。我们报告一名24岁男性,2个月前感冒后出现反复发作的心悸和心前区不适。经胸超声心动图(TTE)和计算机断层扫描肺动脉造影(CTPA)显示右心室心尖部有一肿块以及广泛的双侧肺动脉栓塞。在这名除心肌炎外无任何基础疾病的年轻患者中,未发现血栓的起源部位。进行了肺动脉内膜切除术以及肺动脉和右心室栓子切除术。术后病理结果证实存在纤维蛋白样坏死和含铁血黄素沉积。心室血栓的形成与心肌炎密切相关,心肌炎可影响各年龄段的人,但尤其多见于年轻人。因此,由于广泛血栓形成的风险增加,心肌炎患者应密切监测和随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78c7/9424664/4999f4df661f/fsurg-09-924366-g001.jpg

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