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近期及推测性的远程心肌损伤:病例系列

Recent and speculative remote myocardial trauma: a case series.

作者信息

Lu Zhijuan, Zhang Xiaocong, Huang Yanling, Song Jia, Zhang Chaoqun, Wang Qiang, Wu Handong, Huang Xinsheng

机构信息

Department of Ultrasound, Dongguan Hospital of Guangzhou University of Chinese Medicine, No. 22 Songshan Lake Road, Dongguan 523000, China.

Department of Cardiology, Foshan Fosun Chancheng Hospital, No. 3 Sanyou South Road, Foshan 528000, China.

出版信息

Eur Heart J Case Rep. 2024 Jul 12;8(7):ytae349. doi: 10.1093/ehjcr/ytae349. eCollection 2024 Jul.

Abstract

BACKGROUND

Cardiac blunt trauma clinically presents as a spectrum of injuries of varying severity. However, the diagnosis of complications of remote myocardial trauma is often challenging, especially if the patient forgets to mention a remote history of chest trauma.

CASE SUMMARY

In this study, we present a patient who recently experienced traumatic myocardial dissection and interventricular septal rupture, alongside three patients exhibiting a mimic double-chambered left ventricle, indicative of prior remote myocardial trauma potentially associated with myocardial dissecting tear.

DISCUSSION

Patients with recent severe myocardial injury are detectable through cardiac imaging. However, forgotten remote myocardial trauma can lead to adverse myocardial remodelling, heart failure, and arrhythmias. Long-term myocardial remodelling can obscure initial myocardial imaging characteristics, posing challenges in interpretation. Our case series suggests that remote myocardial trauma may be more prevalent than commonly thought of in clinical practice.

摘要

背景

心脏钝性创伤在临床上表现为一系列严重程度不同的损伤。然而,诊断远期心肌创伤的并发症往往具有挑战性,尤其是当患者忘记提及既往胸部创伤史时。

病例总结

在本研究中,我们报告了一名近期发生创伤性心肌夹层和室间隔破裂的患者,以及三名表现出类似左心室双腔结构的患者,提示既往存在可能与心肌夹层撕裂相关的远期心肌创伤。

讨论

近期发生严重心肌损伤的患者可通过心脏成像检测出来。然而,被遗忘的远期心肌创伤可导致不良的心肌重塑、心力衰竭和心律失常。长期的心肌重塑可掩盖初始心肌成像特征,给解读带来挑战。我们的病例系列表明,远期心肌创伤在临床实践中的发生率可能比通常认为的更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c0e/11276962/ff479ab06175/ytae349f1.jpg

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