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病例报告:尸检显示因结核性心肌炎累及窦房结导致的猝死。

Case report: Sudden unexpected death due to tuberculous myocarditis involving sinus node at autopsy.

作者信息

Zhang Le, Yan He, Wang Yufang, Huang Feijun

机构信息

Forensic Science Center, Gannan Medical University, Ganzhou, China.

Department of Forensic Science, School of Basic Medical Sciences, Central South University, Changsha, China.

出版信息

Front Cardiovasc Med. 2023 Jun 15;10:1159292. doi: 10.3389/fcvm.2023.1159292. eCollection 2023.

Abstract

Tuberculous myocarditis (TM) is an extremely rare manifestation of (TB) infection. Although TM is a critical cause of sudden cardiac death, only a few cases have been reported. We report the case of an older patient with pulmonary TB with a history of fever, chest tightness, paroxysmal palpitations, and electrocardiographic evidence of sinus node conduction abnormalities on admission. Although emergency physicians observed these unusual clinical manifestations, no timely differential diagnosis was made nor interventions were performed. A definitive diagnosis of TM and histopathological findings compatible with sinus node involvement were made based on autopsy outcomes. Herein, we describe the clinical presentation and pathological features of a rare form of . In addition, we provide an overview of issues related to the diagnosis of myocardial TB.

摘要

结核性心肌炎(TM)是结核病(TB)感染极为罕见的一种表现形式。尽管TM是心源性猝死的一个关键原因,但仅有少数病例被报道。我们报告了一例老年肺结核患者,入院时伴有发热、胸闷、阵发性心悸病史,且心电图显示有窦房结传导异常的证据。尽管急诊医生观察到了这些不寻常的临床表现,但未及时进行鉴别诊断,也未采取干预措施。基于尸检结果做出了TM的明确诊断以及与窦房结受累相符的组织病理学发现。在此,我们描述了一种罕见形式的TM的临床表现和病理特征。此外,我们还概述了与心肌结核诊断相关的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c2b/10308008/b2f05e638dd3/fcvm-10-1159292-g001.jpg

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