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成人Fontan循环生理患者诊断肺栓塞的挑战:一例报告

Challenges in diagnosing pulmonary embolism in an adult with Fontan physiology: a case report.

作者信息

Teng Catherine, Shrestha Ribesh, Phillips Jason

机构信息

Division of Cardiology, Department of Medicine, University of Texas Health Science Center San Antonio, TX, USA.

Department of Internal Medicine, University of Texas Health Science Center, San Antonio, TX, USA.

出版信息

Eur Heart J Case Rep. 2023 Jul 22;7(8):ytad330. doi: 10.1093/ehjcr/ytad330. eCollection 2023 Aug.

Abstract

BACKGROUND

With the increasing longevity of congenital heart disease patients and limited number of adult congenital heart disease specialists, it is becoming increasingly imperative for general cardiologists to understand not only the unique physiology of Fontan patients but also imaging protocol considerations when treating this group of patients.

CASE SUMMARY

Here, we present a patient with a history of congenital tricuspid atresia status after the Fontan procedure who presented for gut translocation-related bacteraemia. Importantly, the patient was falsely diagnosed with pulmonary embolism resulting from inaccurate acquisition of computed tomography imaging.

DISCUSSION

This case illustrates the complex intricacies that clinicians should consider when facing the challenge of treating Fontan patients.

摘要

背景

随着先天性心脏病患者寿命的延长以及成人先天性心脏病专家数量有限,对于普通心脏病专家而言,不仅了解Fontan手术患者独特的生理学,而且在治疗这类患者时了解成像方案的注意事项变得越来越迫切。

病例摘要

在此,我们介绍一位在Fontan手术后有先天性三尖瓣闭锁病史的患者,该患者因肠道移位相关菌血症前来就诊。重要的是,该患者因计算机断层扫描成像采集不准确而被误诊为肺栓塞。

讨论

该病例说明了临床医生在面对治疗Fontan手术患者的挑战时应考虑的复杂细节。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8873/10405353/49707e907315/ytad330f1.jpg

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