Matsunaka T, Hara Y, Ikeda S, Hashida H, Kuwahara T, Kawakami H, Okayama H, Hayashi Y, Kodama K, Shigematsu Y, Kohara K, Hamada M, Hiwada K
Second Department of Internal Medicine, Ehime University School of Medicine.
Nihon Ronen Igakkai Zasshi. 1996 Sep;33(9):697-701. doi: 10.3143/geriatrics.33.697.
We report the case of a 66-year-old woman with a patent ductus arteriosus and no significant progression of pulmonary arterial pressure over 17 years. She was admitted to our hospital in 1978 because of palpitations on exertion and chest discomfort. Cardiac catheterization was done, and she was given a diagnosis of patent ductus arteriosus. Because the left-to-right shunt was small (15%) and because there was no evidence of pulmonary hypertension (38/18 mmHg), she was treated medically. In 1995 she was admitted again, to determine the cause of a cerebral infarction. The cerebral infarction was believed to have been caused by an embolism due to atrial fibrillation. She underwent cardiac catheterization again. The left-to-right shunt had increased to 41%, but the pulmonary artery pressure had not changed (27/14 mmHg). Intravascular ultrasound imaging was used to evaluate the ductus arteriosus. The diameter of the ductus was 4.4 mm and calcification was not observed. During the 17 years of follow-up, heart size increased slightly, but pulmonary artery pressure did not change. In addition, intravascular ultrasound was very useful for evaluating the condition of the ductus arteriosus.
我们报告了一例66岁女性患者，患有动脉导管未闭，17年间肺动脉压无显著进展。她于1978年因劳力性心悸和胸部不适入住我院。进行了心导管检查，诊断为动脉导管未闭。由于左向右分流较小（15%）且无肺动脉高压证据（38/18 mmHg），她接受了药物治疗。1995年她再次入院，以确定脑梗死的病因。脑梗死被认为是由房颤导致的栓塞引起的。她再次接受了心导管检查。左向右分流增加到了41%，但肺动脉压未改变（27/14 mmHg）。采用血管内超声成像评估动脉导管。动脉导管直径为4.4 mm，未观察到钙化。在17年的随访期间，心脏大小略有增加，但肺动脉压未改变。此外，血管内超声对于评估动脉导管的状况非常有用。
