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一名年轻亚洲男性表现为二尖瓣狭窄和三尖瓣反流的风湿性心脏病:病例报告

Rheumatic heart disease manifesting as mitral stenosis and tricuspid regurgitation in a young Asian male: a case report.

作者信息

Ko Kyu-Yong, Kim Sung Eun, Hwang Ji-Won, Cho Sung Woo, Kwak Jae-Jin

机构信息

Division of Cardiology, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, 170 Juwha-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do 10380, Republic of Korea.

出版信息

Eur Heart J Case Rep. 2024 Sep 17;8(10):ytae500. doi: 10.1093/ehjcr/ytae500. eCollection 2024 Oct.

DOI:10.1093/ehjcr/ytae500
PMID:39359371
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11443960/
Abstract

BACKGROUND

Rheumatic heart disease (RHD) is a major global health issue because of its potential to cause heart failure. While RHD has been reported more frequently in women, this case report highlights the clinical manifestations, diagnosis, and management of rheumatic multivalvular disease in a young Asian male.

CASE SUMMARY

A 46-year-old Asian man with a history of percutaneous mitral valvuloplasty (PMV) was admitted with dyspnoea and generalized oedema that severely hindered his quality of life. Transthoracic and transoesophageal echocardiography revealed severe mitral stenosis, left atrial appendage (LAA) thrombus, and severe tricuspid regurgitation due to RHD. Following a comprehensive evaluation by a multidisciplinary team, we advised mitral valve replacement, LAA thrombectomy, and tricuspid valve annuloplasty based on the detailed imaging of the valve anatomy and the patient's low surgical risk. Surgical intervention led to considerable improvement in the patient's symptoms, enabling a return to routine activities.

DISCUSSION

This case highlights the chronic nature of RHD and its potential to cause heart failure. This report emphasizes the need for regular follow-up in patients with a history of RHD to detect potential complications and ensure timely management. The successful outcome in this case underscores the importance of a team-based approach for managing complex valvular heart disease.

摘要

背景

风湿性心脏病(RHD)因其有导致心力衰竭的可能性,是一个重大的全球健康问题。虽然RHD在女性中报道更为频繁,但本病例报告重点介绍了一名年轻亚洲男性风湿性多瓣膜病的临床表现、诊断和管理。

病例摘要

一名有经皮二尖瓣球囊成形术(PMV)病史的46岁亚洲男性因呼吸困难和全身性水肿入院,这些症状严重影响了他的生活质量。经胸和经食管超声心动图显示,由于RHD导致严重二尖瓣狭窄、左心耳(LAA)血栓形成和严重三尖瓣反流。在多学科团队进行全面评估后,根据瓣膜解剖结构的详细成像以及患者较低的手术风险,我们建议进行二尖瓣置换、LAA血栓切除术和三尖瓣瓣环成形术。手术干预使患者症状得到显著改善,能够恢复日常活动。

讨论

本病例突出了RHD的慢性性质及其导致心力衰竭的可能性。本报告强调,有RHD病史的患者需要定期随访,以发现潜在并发症并确保及时管理。该病例的成功结果强调了基于团队的方法管理复杂瓣膜性心脏病的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b38/11443960/1b320c837a28/ytae500f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b38/11443960/0a9e2c4a7528/ytae500il2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b38/11443960/c0c4403d3404/ytae500f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b38/11443960/85f2fe68e146/ytae500f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b38/11443960/70c84cdb6ba2/ytae500f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b38/11443960/1b320c837a28/ytae500f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b38/11443960/0a9e2c4a7528/ytae500il2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b38/11443960/c0c4403d3404/ytae500f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b38/11443960/85f2fe68e146/ytae500f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b38/11443960/70c84cdb6ba2/ytae500f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b38/11443960/1b320c837a28/ytae500f4.jpg

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