Shah A, Melarkey D, Ness V T
Department of Medicine, University of Nevada School of Medicine, Reno.
Chest. 1993 Jul;104(1):285-6. doi: 10.1378/chest.104.1.285.
A case of extrinsic nonvalvular mitral obstruction due to a large epicardial hematoma in a patient with rheumatoid constrictive pericarditis is described. The patient had longstanding rheumatoid arthritis and a mitral diastolic murmur developed. Mitral obstruction was confirmed by a hemodynamic study. Coronary angiography and left ventricular angiography showed severely diseased coronary arteries and a distorted left ventricular cavity. Autopsy demonstrated rheumatoid arthritis, a normal mitral valve, thickened pericardium, and epicardial hematoma surrounding both ventricles at the atrioventricular junctional level.
本文描述了一例类风湿性缩窄性心包炎患者因巨大的心外膜血肿导致外在性非瓣膜性二尖瓣梗阻的病例。该患者患有长期类风湿性关节炎，出现了二尖瓣舒张期杂音。通过血流动力学研究证实了二尖瓣梗阻。冠状动脉造影和左心室造影显示冠状动脉严重病变以及左心室腔变形。尸检发现有类风湿性关节炎、正常的二尖瓣、增厚的心包以及在房室交界水平围绕两个心室的心外膜血肿。
