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一例伴有穿孔的室间隔假性动脉瘤酷似室间隔缺损的病例。

A Case of an Interventricular Septum Pseudoaneurysm With Perforation Mimicking a Ventricular Septal Defect.

作者信息

Jamil Dawood, Fadel Raef, Kollman Patrick, Swanson Benjamin

机构信息

Internal Medicine, Henry Ford Health System, Detroit, USA.

Cardiology, Henry Ford Health System, Detroit, USA.

出版信息

Cureus. 2024 Nov 5;16(11):e73080. doi: 10.7759/cureus.73080. eCollection 2024 Nov.

DOI:10.7759/cureus.73080
PMID:39640109
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11620786/
Abstract

Ventricular pseudoaneurysm (PSA) is a ventricular outpouching contained by adherent pericardium or myocardial scar tissue and represents a rare but potentially fatal complication of acute myocardial infarction (AMI). The vast majority of cases involve the left ventricular apex, in the area of infarct. It is extremely rare to see PSA formation within the interventricular septum (IVS). We present a case of ventricular PSA of the IVS, with contained perforation into the right ventricle, mimicking a ventricular septal defect (VSD) in a patient presenting with ST-elevation myocardial infarction (STEMI). This case underscores the importance of maintaining a high index of clinical suspicion and reviews the pathophysiological mechanisms and treatment options for these life-threatening mechanical complications.

摘要

心室假性动脉瘤（PSA）是一种由粘连的心包或心肌瘢痕组织包裹的心室膨出，是急性心肌梗死（AMI）罕见但可能致命的并发症。绝大多数病例累及梗死区域的左心室心尖。室间隔（IVS）内出现PSA形成极为罕见。我们报告一例IVS的心室PSA病例，伴有穿孔进入右心室，在一名表现为ST段抬高型心肌梗死（STEMI）的患者中酷似室间隔缺损（VSD）。该病例强调了保持高度临床怀疑的重要性，并回顾了这些危及生命的机械性并发症的病理生理机制和治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d692/11620786/36d82bb570f6/cureus-0016-00000073080-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d692/11620786/2ff865729e94/cureus-0016-00000073080-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d692/11620786/573ab52dcaea/cureus-0016-00000073080-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d692/11620786/36d82bb570f6/cureus-0016-00000073080-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d692/11620786/2ff865729e94/cureus-0016-00000073080-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d692/11620786/573ab52dcaea/cureus-0016-00000073080-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d692/11620786/36d82bb570f6/cureus-0016-00000073080-i03.jpg

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本文引用的文献

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Left ventricular pseudoaneurysm: the niche of post-infarction mechanical complications.左心室假性动脉瘤：心肌梗死后机械性并发症的病灶
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Post-infarction ventricular septal rupture.心肌梗死后室间隔破裂
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Left ventricular pseudoaneurysm.左心室假性动脉瘤。
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8
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