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无症状患者双腔左心室合并血栓:一例报告

Double-chambered left ventricle with a thrombus in an asymptomatic patient: A case report.

作者信息

Kim Narae, Yang In-Ho, Hwang Hui-Jeong, Sohn Il-Suk

机构信息

Department of Medicine, Kyung Hee University, Seoul 02447, South Korea.

Department of Cardiology, Kyung Hee University Hospital at Gangdong, Seoul 05278, South Korea.

出版信息

World J Clin Cases. 2024 Jan 16;12(2):460-465. doi: 10.12998/wjcc.v12.i2.460.

Abstract

BACKGROUND

Double-chambered left ventricle (DCLV) is an extremely rare congenital disease in which the left ventricle (LV) is divided by abnormal muscle tissue. Due to its rarity, there is a lack of data on the disease, including its diagnosis, treatment, and prognosis. Accordingly, we report a case in which DCLV was diagnosed and followed up.

CASE SUMMARY

A 45-year-old man presented to our hospital due to abnormal findings on an electrocardiogram recorded during a health check. He had no specific cardiac symptoms, comorbidities or relevant past medical history. Echocardiography revealed that the LV was divided into two by muscle fibers. There were no findings of ischemia on coronary angiography and coronary computed tomography angiography performed to exclude differential diagnoses. After comprehensive analysis of the images, DCLV was diagnosed. As it seemed to be asymptomatic DCLV, we decided the patient was to be observed without administering any medication. However, follow-up echocardiography revealed a thrombus in the accessory chamber (AC). Anticoagulant medication was initiated, the thrombus resolved, and the patient is currently undergoing follow-up without any specific symptoms.

CONCLUSION

Asymptomatic, uncomplicated DCLV was diagnosed through multimodal imaging; however, a thrombus in the AC occurred during the follow-up. The findings highlight that multimodal imaging is essential in diagnosing DCLV, and that anticoagulation is important in its management.

摘要

背景

双腔左心室(DCLV)是一种极为罕见的先天性疾病,其中左心室(LV)被异常肌肉组织分隔。由于其罕见性,关于该疾病的数据匮乏,包括其诊断、治疗和预后。因此,我们报告一例DCLV的诊断及随访病例。

病例摘要

一名45岁男性因健康检查时心电图异常结果前来我院就诊。他无特定心脏症状、合并症或相关既往病史。超声心动图显示左心室被肌纤维分为两部分。为排除鉴别诊断而进行的冠状动脉造影和冠状动脉计算机断层血管造影未发现缺血表现。综合分析图像后,诊断为DCLV。由于似乎是无症状性DCLV,我们决定对患者进行观察,不给予任何药物治疗。然而,随访超声心动图显示副腔(AC)内有血栓形成。开始使用抗凝药物,血栓溶解,患者目前正在接受随访,无任何特定症状。

结论

通过多模态成像诊断出无症状、无并发症的DCLV;然而,随访期间副腔内出现了血栓。这些发现突出表明多模态成像对DCLV的诊断至关重要,抗凝在其管理中也很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44a2/10835694/54138f0b5e27/WJCC-12-460-g001.jpg

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本文引用的文献

1
A double-chambered left ventricle with a giant thrombus: a case report.一例伴有巨大血栓的双腔左心室病例报告。
Eur Heart J Case Rep. 2023 Mar 28;7(4):ytad129. doi: 10.1093/ehjcr/ytad129. eCollection 2023 Apr.
5
Double-chambered left ventricle: A rare case in a child.双腔左心室:儿童中的罕见病例。
Echocardiography. 2019 Jan;36(1):192-195. doi: 10.1111/echo.14193. Epub 2018 Nov 20.
6
Double-chambered left ventricle in a patient with chest pain.一名胸痛患者的双腔左心室。
Clin Res Cardiol. 2018 Dec;107(12):1180-1182. doi: 10.1007/s00392-018-1298-z. Epub 2018 Jun 14.
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Double-chambered left ventricle in an adult: diagnosis by CMRI.成人双腔左心室:心脏磁共振成像诊断
Clinics (Sao Paulo). 2010;65(12):1393-5. doi: 10.1590/s1807-59322010001200028.
10
A heart within the heart: double-chambered left ventricle.心内之心:双腔左心室
Eur J Echocardiogr. 2008 Sep;9(5):739-41. doi: 10.1093/ejechocard/jen158. Epub 2008 May 7.

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