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頁籤選單縮合
題名 | How Long can He Live? A Case of Asymptomatic ASD=心房中隔缺損患者存活至九十二歲--一病例報告 |
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作者姓名(中文) | 璩大維; 丁予安; | 書刊名 | Acta Cardiologica Sinica |
卷期 | 13:4 民86.10-12 |
頁次 | 頁214-218 |
分類號 | 415.315 |
關鍵詞 | 心房中隔缺損; Atrial septal defect; ASD; |
語文 | 英文(English) |
中文摘要 | 背景:心房中隔缺損是僅次於雙葉主動脈瓣最常見的先天性心臟病,早期的文 獻報告顯示,自然存活超過六十歲者已不到百分之十,而超過九十歲者則只有兩例,分別為 96 和 94 歲。本文將描述一名九十二歲老人經檢查證實診斷為心房中隔缺損第二型。 我們 相信這應該是全臺灣存活最久的心房中隔缺損病例。病例報告: 一位 92 歲老人因為肺炎及 心臟衰竭而前來住院,心電圖顯示心房顫動及撲動合併右束支傳導阻斷,右心室過勞現象。 胸部 X 光有心臟擴大合併肺動脈鼓脹,主動脈縮小。 經食道心臟超音波可見心房中隔缺損 1.6 公分及左心房至右心房血流。肺動脈導管顯示右心房血流氧氣濃度上升。此病人因心臟 衰竭合併肺炎及敗血性休克而死亡。結論: 此病人的長壽似乎應該歸功於長期過著輕鬆的日 常生活以及不算大的中隔缺損。 我們認為,經由仔細地理學檢查,心電圖及 X 光判讀,可 能有更多地成人心房中隔缺損病例會被發現;而在決定病患的治療方式時,亦可較有彈性。 |
英文摘要 | Background. Atrial septal defect (ASD)is not uncommonly seen in adult person. According to the literature, two persons with this congenital defect have normal lived exceeding 90 years; the older survivor was 96 and the other lived to 94 years old. This description concerns a person with ASD who lived to be 92 years old, and is believed to be the oldest ASD in Taiwan. Methods and Results. A 92-year-old male was found to have atrial septal defect (ASD), secundum type, without any previous obvious cardiac symptoms or sign before. Chest X-ray showed a marked increase in pulmonary vascularity, enlargement of the pulmonary arteries and the right atrium. The electrocardiogram (ECG) demonstrated artial flutter-fibrillation, marked right axis deviation and right ventricular hypertrophy. Echocardiography revealed marked diatation of the right atrium and right ventricle, transesophageal echocardiogram showed an opening in the mid-portion of the inter-atrial septum with 1.6 cm in width. Pulmonary catheterization showed O2 saturation step up at the right atrium. The patient died of congestive heart failure superimposed with pneumonia and sepsis. Conclusion. It is interesting that this patient with ASD could survive to such an age. By careful physical examination, there may be more asymptomatic ASD patients may be found. This case, we suggest that a long-term therapeutic strategy can be more flexible for patient with asymptomatic ASD if we provide a careful clinical follow-up. |
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