von Bartheld Bob, Rijnierse Mischa, van Loon Ramon, Meijboom Lilian
Department of Cardiology, St Jansdal Hospital, Wethouder Jansenlaan 90, P.O. Box 138, Harderwijk 3840 AC, The Netherlands.
Department of Cardiology, Amsterdam University Medical Center, PO Box 7057, Amsterdam, 1081 HV, The Netherlands.
Eur Heart J Case Rep. 2023 Feb 13;7(3):ytad082. doi: 10.1093/ehjcr/ytad082. eCollection 2023 Mar.
Cor triatriatum sinistra (CTS) is a rare condition where the left atrium (LA) is divided by a thin membrane into an upper and lower chamber. Incidentally, the diagnosis is made in late adulthood, usually because of a favourable variant such as in our patient who presented with partial CTS.
We present the case of a 62-year-old female who presented with COVID-19. She was known for longstanding symptoms of dyspnoea on exertion as well as a minor stroke several years ago. Computed tomography on admission suggested there was a mass in the LA but transthoracic echocardiography and cardiac magnetic resonance imaging revealed the diagnosis of partial CTS in which the superior compartment received pulmonary venous drainage from the right lung and the left-sided pulmonary veins drained into the inferior chamber. Since there were signs of chronic pulmonary oedema she successfully underwent balloon dilatation of the membrane resulting in remission of symptoms and normalization of the pressure in the accessory chamber.
Partial CTS is a rare variant of CTS. Since part of the pulmonary veins drains in the lower chamber of the LA (and thereby unload the right ventricle), it is a favourable variant and patients may present later in life when membrane orifices calcify or it may be discovered as an incidental finding. In some patients requiring intervention, balloon dilatation of the membrane may be considered as an alternative to surgical removal of the membrane by thoracotomy.
先天性左房三房心(CTS)是一种罕见的疾病,左心房(LA)被一层薄膜分隔为上、下两个腔室。偶然的情况下,这种疾病常在成年后期被诊断出来,通常是因为存在一些有利的变异情况,比如我们的患者所表现出的部分三房心。
我们报告一例62岁患新型冠状病毒肺炎(COVID-19)的女性病例。她长期存在劳力性呼吸困难症状,并且在数年前曾有过一次轻度中风。入院时的计算机断层扫描显示左心房有一个肿块,但经胸超声心动图和心脏磁共振成像检查确诊为部分三房心,其中上腔室接收来自右肺的肺静脉引流,而左侧肺静脉则引流至下腔室。由于存在慢性肺水肿的迹象,她成功接受了膜球囊扩张术,症状得到缓解,附属腔室压力恢复正常。
部分三房心是三房心的一种罕见变异类型。由于部分肺静脉引流至左心房的下腔室(从而减轻右心室的负担),这是一种有利的变异情况,患者可能在晚年因膜孔钙化而出现症状,或者可能作为偶然发现被诊断出来。对于一些需要干预的患者,膜球囊扩张术可被视为开胸手术切除膜的替代方法。