Abrams L D, Cole R B, Cumming G, Harding L K, Housley E, Prowse K
Thorax. 1969 May;24(3):368-71. doi: 10.1136/thx.24.3.368.
A 60-year-old woman developed subacute bacterial endocarditis following a minor operation. She presented the unusual picture of breathlessness with cyanosis related to posture, confirmed by laboratory measurement. She had an atrial septal defect with right-to-left shunt, and had sustained multiple pulmonary infarcts, resulting in the obliteration of a large section of her pulmonary vascular bed. The puzzling absence of pulmonary hypertension was explained by tricuspid incompetence, although there was no clinical evidence of this, and on two occasions the right atrial pressure tracing was normal. The use of a balloon catheter to predict the results of operation is described. At operation the severely damaged tricuspid valve was replaced, and the septal defect was closed. There was an immediate improvement in the arterial oxygen tension after operation. She subsequently survived an episode of ventricular fibrillation, left hospital 11 months after her original admission and is now leading a normal life.
一名60岁女性在一次小手术后患上亚急性细菌性心内膜炎。她表现出与体位相关的呼吸困难伴发绀的不寻常症状，经实验室检测得以证实。她患有房间隔缺损伴右向左分流，并发生了多次肺梗死，导致其大部分肺血管床闭塞。尽管没有临床证据表明存在三尖瓣关闭不全，但这一情况解释了令人费解的肺动脉高压缺失现象，而且有两次右心房压力描记正常。文中描述了使用球囊导管来预测手术结果的情况。手术中更换了严重受损的三尖瓣，并封闭了房间隔缺损。术后动脉血氧张力立即得到改善。她随后在一次心室颤动发作后存活下来，在首次入院11个月后出院，现在过着正常生活。
