Hermann H, Raizner A E, Chahine R A, Luchi R J
South Med J. 1976 Sep;69(9):1222-5. doi: 10.1097/00007611-197609000-00036.
A patient with classical clinical and roentgenographic features of congenital absence of the left pericardium is described. On physical examination in the supine position, the precordial apical impluse was markedly displaced laterally. In the left lateral decubitus position, however, the apical impulse was felt in a mor medial location. This apparently paradoxical movement of the apical impulse was not found in persons with normal hearts or with left ventricular enlargement of hypertrophy, and may be characteristic of the pericardial defect. Further, with echocardiography we were able to demonstrate the absence of a pericardial echo on the lateral surface of the heart. Thus, echocardiography may be a useful noninvasive tool in the diagnosis of this defect.
本文描述了一名具有先天性左心包缺如典型临床和影像学特征的患者。仰卧位体格检查时，心前区心尖搏动明显向外侧移位。然而，在左侧卧位时，心尖搏动位于更内侧的位置。这种明显矛盾的心尖搏动在心脏正常或左心室肥厚扩大的患者中未发现，可能是心包缺损的特征。此外，通过超声心动图，我们能够证实心脏外侧表面无心包回声。因此，超声心动图可能是诊断这种缺损的一种有用的非侵入性工具。
