[左心室真性动脉瘤与假性动脉瘤鉴别诊断中的困难。病例报告]
[Difficulties in distinguishing left ventricular aneurysm from pseudoaneurysm. Case report].
作者信息
Hirnle T, Sobkowicz B, Bross T, Tomaszewski P, Nowosad H, Krupacz R
机构信息
Klinika Chirurgii Serca Akademii Medycznej we Wrocławiu.
出版信息
Pol Arch Med Wewn. 1998 Mar;99(3):228-32.
A case of 51-year old female with large inferior left ventricular aneurysm developed 3 months after myocardial infarction is presented. The patient demonstrated advanced congestive heart failure and angina. Coronarography revealed amputation of the distal part of 3 coronary vessels without possibility of revascularisation. In ventriculography large inferior wall aneurysm was found. Echocardiography strongly suggest the presence of pseudoaneurysm. During the operation very large real aneurysm arising from inferior wall and apex was found. Postoperative period was complicated by many cardiac and non cardiac events. Authors discuss the problems of proper diagnostic and its influence on decision about surgical management.
本文介绍了一例51岁女性患者，在心肌梗死后3个月出现巨大左心室下壁动脉瘤。患者表现为重度充血性心力衰竭和心绞痛。冠状动脉造影显示3支冠状动脉远端截断，无法进行血运重建。心室造影发现巨大下壁动脉瘤。超声心动图强烈提示存在假性动脉瘤。手术中发现一个源于下壁和心尖的非常大的真性动脉瘤。术后出现了许多心脏和非心脏并发症。作者讨论了正确诊断的问题及其对手术治疗决策的影响。
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