无前驱心肌梗死的左心室假性动脉瘤。
Left ventricular pseudoaneurysm without antecedent myocardial infarction.
作者信息
Naseerullah Fahad Syed, Pyle William, Addai Theodore, Murthy Avinash
机构信息
Department of Internal Medicine, Houston Methodist Sugar Land Hospital, Houston, TX, USA.
Department of Cardiovascular Surgery, Ilinois University School of Medicine, Springfield, IL, USA.
出版信息
J Cardiol Cases. 2023 Mar 24;28(1):24-27. doi: 10.1016/j.jccase.2023.03.003. eCollection 2023 Jul.
UNLABELLED
A left ventricle pseudoaneurysm (LVPA) occurs when the left ventricle free wall rupture becomes contained by pericardium or adhesions. It is rare and has a poor prognosis. LVPA is strongly associated with myocardial infarction. Surgical management of LVPA carries a high mortality rate but is still recommended for most cases of LVPA as soon as the diagnosis is confirmed. Medical management is generally limited to asymptomatic, incidentally found lesions. We present a case of LVPA without any usual risk factors, which was successfully treated by surgery.
LEARNING OBJECTIVES
•To identify the left ventricle pseudoaneurysm (LVPA) that can present with chest pain or dyspnea, but at times can be asymptomatic•To keep a high index of suspicion for LVPA even in patients without the common risk factors such as recent myocardial infarction, cardiac surgery, or trauma•To realize that management options are individualized•To understand that despite a high surgical mortality, for large expanding LVPA, surgery is still recommended•Further research needs to be done to establish management guidelines.
未标注
左心室假性动脉瘤（LVPA）是指左心室游离壁破裂后被心包或粘连组织包裹形成的病变。它较为罕见，预后较差。LVPA与心肌梗死密切相关。LVPA的手术治疗死亡率较高，但一旦确诊，对于大多数LVPA病例仍建议尽早进行手术。药物治疗通常仅限于无症状的、偶然发现的病变。我们报告一例无任何常见危险因素的LVPA病例，该病例通过手术成功治愈。
学习目标
•识别可表现为胸痛或呼吸困难，但有时也可无症状的左心室假性动脉瘤（LVPA）•即使在没有近期心肌梗死、心脏手术或创伤等常见危险因素的患者中，也要对LVPA保持高度怀疑•认识到治疗方案是个体化的•理解尽管手术死亡率较高，但对于较大且不断扩大的LVPA，仍建议进行手术•需要进一步研究以建立治疗指南。
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