Delgado C, Durán R M, Serra E, Barturen F
Service of Cardiology, Pathological Anatomy, and Intensive Care Unit, Policlínica Miramar, Palma de Mallorca, Spain.
J Am Soc Echocardiogr. 1997 Jun;10(5):582-7. doi: 10.1016/s0894-7317(97)70016-6.
A 65-year-old man was readmitted to the hospital with deep-vein thrombophlebitis 3 weeks after suffering a small infarction. Two days after the patient was readmitted severe symptoms of cardiac failure developed. Transthoracic echocardiographic examination showed an unusual echo-free space adjacent to the lateral wall of the left atrium. No further diagnostic information could be obtained from precordial examinations. Single-plane transesophageal echocardiography demonstrated the presence of a ruptured aneurysm in the posterolateral wall of the left ventricle and a pseudoaneurysm, which was severely compressing the left atrial cavity. On color-flow Doppler examination a tear was detected in the wall of the left ventricular aneurysm close to the posterior atrioventricular sulcus. Pericardial adhesions because of coronary artery bypass grafting performed 10 years before may have contributed to the unusual location of this left ventricular pseudoaneurysm, complicated with left atrium tamponade after myocardial infarction.
一名65岁男性在发生小面积梗死3周后因深静脉血栓性静脉炎再次入院。患者再次入院两天后出现严重心力衰竭症状。经胸超声心动图检查显示左心房侧壁附近有一个异常的无回声区。心前区检查未能获得更多诊断信息。单平面经食管超声心动图显示左心室后壁有一个破裂的动脉瘤和一个假性动脉瘤，该假性动脉瘤严重压迫左心房腔。彩色多普勒血流检查发现左心室动脉瘤壁靠近后房室沟处有一处撕裂。10年前进行的冠状动脉搭桥手术导致的心包粘连可能是造成该左心室假性动脉瘤位置异常的原因，该假性动脉瘤并发心肌梗死后左心房填塞。
