航空病理学联合委员会：十三、结节病与心脏——一种航空医学风险。

Joint Committee on Aviation Pathology: XIII. Sarcoid and the heart--an aeromedical risk.

作者信息

Pettyjohn F S, Spoor D H, Buckendorf W A

出版信息

Aviat Space Environ Med. 1977 Oct;48(10):955-8.

Abstract

Sarcoid lesions of the heart are reported in 13% to 20% of sarcoidosis patients. Sudden death and ventricular arrhythmias occur in 40% to 50%. In view of this frequency and life-threatening significance, review of military aircrew with documented sarcoidosis for myocardial involvement was undertaken. Case records were available for 11 US Army, 19 US Air Force, and 6 US Navy patients. Four patients (11%) had significant cardiac abnormalities to include sustained ventricular arrhythmias, and acquired anteroseptal infarction pattern by ECG with nomal coronary angiography. ECG abnormalities were found in eight additional patients. Suspected involvement of the heart in 33% of this series warrants complete cardiovascular evaluation of the sarcoid patient prior to return to flying duties. A case report demonstrates the difficulty in evaluating ECG abnormalities in the antemortem diagnosis of sarcoid heart disease.

摘要

结节病患者中，有13%至20%的人会出现心脏结节病病变。40%至50%的患者会发生猝死和室性心律失常。鉴于这种高发性和危及生命的严重性，对有结节病记录的军事飞行人员进行了心肌受累情况的检查。有11名美国陆军、19名美国空军和6名美国海军患者的病例记录可供查阅。4名患者（11%）有明显的心脏异常，包括持续性室性心律失常，心电图显示有获得性前间隔梗死模式，而冠状动脉造影正常。另有8名患者发现心电图异常。本系列中33%的患者疑似心脏受累，这表明在结节病患者恢复飞行任务之前，有必要对其进行全面的心血管评估。一份病例报告显示了在结节病性心脏病的生前诊断中评估心电图异常的困难。