Schweisfurth H, Jachmann M, Schoettes C, Lorenz H
Pulmonary Hospital, Muennerstadt, Germany.
Monaldi Arch Chest Dis. 1994 Jun;49(3):211-3.
We report the case of a white male aged 21 yrs, who was admitted for acute onset of haemoptysis. His past medical history was normal and he had not previously been hospitalized. He was very active in track and field sports and was trained in scuba-diving. Physical examination revealed a grade 2/6 holosystolic heart murmur. Laboratory parameters, blood gases and pulmonary function tests were within the normal range. Fibreoptic bronchoscopy revealed normal geometry of the bronchi, with blood clots in the left lower lobe. An X-ray of the chest showed that the heart was shifted to the left side. In the perfusion scan, defects of the tracer on the left lung were detected. By ergospirometry, no significantly pathological response to exercise using a bicycle ergometer could be observed. By means of pulmonary artery catheterization, cardioangiography and selective angiography of the aorta the absence of the left pulmonary artery could be established, without any further malformations of the cardiopulmonary system. Because of the spontaneous cessation of haemoptysis, no surgical intervention was necessary.
我们报告一例21岁白人男性病例，该患者因急性咯血入院。他既往病史正常，此前未住过院。他非常热衷于田径运动，还接受过潜水训练。体格检查发现有2/6级全收缩期心脏杂音。实验室指标、血气分析和肺功能测试均在正常范围内。纤维支气管镜检查显示支气管形态正常，但左肺下叶有血凝块。胸部X线片显示心脏向左移位。在灌注扫描中，检测到左肺有示踪剂缺损。通过运动肺量计检查，未观察到使用自行车测力计运动时出现明显的病理反应。通过肺动脉导管插入术、心血管造影和主动脉选择性血管造影，确定左肺动脉缺如，且心肺系统无其他畸形。由于咯血自行停止，无需进行手术干预。
