Lees Elizabeth H, Cardozo Torres Hernan, Edell Eric S, Cortes Puentes Gustavo, Foley Thomas A, Reisenauer Janani S, Allison Thomas G
Department of Internal Medicine, Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
Respir Med Case Rep. 2024 Sep 24;52:102109. doi: 10.1016/j.rmcr.2024.102109. eCollection 2024.
It is rare for an adult patient to be living decades after a pneumonectomy procedure. This case features complications that can arise. We utilize cardiopulmonary exercise stress testing (CPET) to highlight long-term physiologic changes that can present in a post-pneumonectomy patient.
A 53-year-old woman presented for cardiopulmonary exercise stress testing (CPET) to assess worsening dyspnea on exertion with associated chest pressure. She had a history of traumatic right-sided pneumonectomy at age 27 years complicated by post-pneumonectomy syndrome. Her CPET was suboptimal with marked deficiencies that were most consistent with a primary ventilation limitation causing her reduced exercise capacity.
DISCUSSION/CONCLUSION: A thorough literature search did not return any similar cases using CPET to evaluate a post-pneumonectomy patient. The abnormal anatomy results in a unique set of CPET values. Her ventilatory insufficiency is likely made worse by her post-pneumonectomy syndrome. Her treatment options are limited.
成年患者在肺切除术后存活数十年的情况较为罕见。本病例具有可能出现的并发症。我们利用心肺运动应激试验（CPET）来突出肺切除术后患者可能出现的长期生理变化。
一名53岁女性因心肺运动应激试验（CPET）前来就诊，以评估运动时呼吸困难加重及伴有胸痛的情况。她在27岁时因创伤性右侧肺切除术，并发肺切除术后综合征。她的CPET结果不理想，存在明显缺陷，最符合原发性通气受限导致其运动能力下降。
讨论/结论：全面的文献检索未发现使用CPET评估肺切除术后患者的类似病例。异常的解剖结构导致了一组独特的CPET值。她的通气不足可能因肺切除术后综合征而加重。她的治疗选择有限。
