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巨大左心房及其处理方式(手术治疗与保守治疗):来自毛里塔尼亚的一例病例报告

Giant left atrium and management modalities (surgical vs. conservative): a case report from Mauritania.

作者信息

Med Sidi El Moctar Echreiva, El Hadj Sidi Chighaly, Abdulrazzak Mohammed, Eldeghedi Maher, Thoraya Abdelghader, Boye Khaled

机构信息

Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Center National de Cardiology, Nouakchott, Mauritania.

出版信息

Ann Med Surg (Lond). 2023 Aug 4;85(9):4624-4628. doi: 10.1097/MS9.0000000000001132. eCollection 2023 Sep.

Abstract

INTRODUCTION AND IMPORTANCE

Giant left atrium (GLA) is a rare condition often associated with rheumatic heart disease and can lead to cardiac and extracardiac complications. In this case report, the authors present a rare case of GLA with extracardiac complications, highlighting the importance of prompt diagnosis and management.

CASE PRESENTATION

A 54-year-old woman with a 25-year history of mitral stenosis caused by rheumatic heart disease presented with symptoms of dyspnea, orthopnea, and palpitations. Diagnostic tests revealed an enlarged left atrium, pleural effusion, severe pulmonary hypertension, and tricuspid regurgitation. The patient was treated with diuretics and ACE (angiotensin-converting enzyme) inhibitors and is currently on a medication regimen with regular follow-up appointments.

CLINICAL DISCUSSION

GLA can cause cardiac and extracardiac complications, and conservative treatment and surgery are both involved in the management plan. The reduction of left atrial size by surgery may eliminate symptoms, reduce postoperative complications, and increase the probability of regaining sinus rhythm.

CONCLUSION

Observational data on managing GLA is limited, and mortality can be high. Cardiovascular surgeons should carefully consider surgical options, and screening and follow-up are essential for early detection and management in patients with long-standing rheumatic heart disease.

摘要

引言与重要性

巨大左心房(GLA)是一种罕见病症,常与风湿性心脏病相关,可导致心脏及心脏外并发症。在本病例报告中,作者呈现了一例伴有心脏外并发症的罕见GLA病例,强调了及时诊断和管理的重要性。

病例介绍

一名54岁女性,有风湿性心脏病导致二尖瓣狭窄25年病史,出现呼吸困难、端坐呼吸和心悸症状。诊断检查显示左心房增大、胸腔积液、重度肺动脉高压和三尖瓣反流。患者接受了利尿剂和ACE(血管紧张素转换酶)抑制剂治疗,目前正在接受药物治疗方案并定期随访。

临床讨论

GLA可引起心脏及心脏外并发症,管理计划包括保守治疗和手术。手术减小左心房大小可消除症状、减少术后并发症并增加恢复窦性心律的可能性。

结论

关于GLA管理的观察性数据有限,死亡率可能很高。心血管外科医生应仔细考虑手术选择,筛查和随访对于长期风湿性心脏病患者的早期发现和管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfe7/10473379/efdf182b86eb/ms9-85-4624-g001.jpg

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