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无症状青年成人的四叶式主动脉瓣:一例报告

Quadricuspid aortic valve in an asymptomatic young adult: a case report.

作者信息

Karki Parag, Kc Sharada, Bastakoti Aashish, Khatiwada Abhikanta

机构信息

Department of Internal Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.

Department of General Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

出版信息

Ann Med Surg (Lond). 2025 Jan 21;87(2):1034-1037. doi: 10.1097/MS9.0000000000002920. eCollection 2025 Feb.

Abstract

INTRODUCTION

Quadricuspid aortic valve (QAV) is a rare congenital heart disease, ranking behind bicuspid and unicuspid aortic valves in terms of the incidence of congenital aortic valve abnormalities. When symptoms are present, they are typically related to aortic regurgitation, manifesting as shortness of breath, nocturnal dyspnea, and palpitations, or aortic stenosis, which presents with exertional dyspnea, angina, or syncope.

CASE PRESENTATION

We present the case of an asymptomatic male, diagnosed with a QAV during a routine examination. Despite the absence of clinical symptoms, a thorough general physical examination, including cardiac auscultation, revealed signs suggestive of valvular abnormality. The diagnosis was confirmed via transthoracic echocardiography.

CLINICAL DISCUSSION

For QAV, the diagnostic process typically includes transthoracic echocardiography, which allows for initial confirmation of the valve morphology. In addition, computed tomography (CT) coronary angiography provides detailed information on valvular morphology and helps identify any associated coronary stenosis. In cases of QAV, a CT aortogram is also crucial to assess potential aortic root dilation, a known complication of this congenital anomaly.

CONCLUSION

This case emphasizes the importance of routine physical examination in diagnosing rare congenital heart conditions like QAV, even in asymptomatic individuals. Early diagnosis and appropriate imaging are essential for timely management, particularly in preventing the progression of associated complications such as aortic regurgitation or root dilation.

摘要

引言

四叶式主动脉瓣(QAV)是一种罕见的先天性心脏病,在先天性主动脉瓣异常的发病率方面仅次于二叶式和单叶式主动脉瓣。出现症状时,通常与主动脉瓣反流有关,表现为呼吸急促、夜间呼吸困难和心悸,或与主动脉瓣狭窄有关,表现为劳力性呼吸困难、心绞痛或晕厥。

病例介绍

我们报告一例无症状男性病例,在常规检查中被诊断为QAV。尽管没有临床症状,但包括心脏听诊在内的全面体格检查发现了提示瓣膜异常的体征。经胸超声心动图证实了诊断。

临床讨论

对于QAV,诊断过程通常包括经胸超声心动图,它可以初步确认瓣膜形态。此外,计算机断层扫描(CT)冠状动脉造影可提供有关瓣膜形态的详细信息,并有助于识别任何相关的冠状动脉狭窄。对于QAV病例,CT主动脉造影对于评估潜在的主动脉根部扩张也至关重要,这是这种先天性异常的一种已知并发症。

结论

该病例强调了常规体格检查在诊断像QAV这样罕见的先天性心脏病中的重要性,即使是无症状个体。早期诊断和适当的影像学检查对于及时管理至关重要,特别是在预防相关并发症如主动脉瓣反流或根部扩张的进展方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/066e/11918704/624ade0046dc/ms9-87-1034-g001.jpg

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