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題 名 | Isolated Primary Atrial Septal Aneurysm--A Case Report=孤立性原發性心房中膈瘤--一病例報告 |
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作 者 | 李茂琦; 朱凱民; 王賡堯; 葉祖青; | 書刊名 | Acta Cardiologica Sinica |
卷 期 | 14:1 民87.01-03 |
頁 次 | 頁35-41 |
分類號 | 415.315 |
關鍵詞 | 心房中膈瘤; Atrial septal aneurysm; |
語 文 | 英文(English) |
中文摘要 | 背景:原發性心房中膈瘤是一種先天性的心內膜構造冗贅的結締組織缺陷。文獻記載,成人原發性心房中膈瘤的流行率大約在1%上下。原發性心房中膈瘤在大多數病人通常無症狀,而心悸是最常見的症狀;除非有心房間血液分流存在,否則原發性心房中膈瘤是不會影響血流動態。然而有文獻報告關於心房中膈瘤和腦部血管栓塞之間的關聯性。 方法與結果:一位二十歲男性因心臟雜音在門診接受胸前心臟超音波檢查,發現一個心房中膈瘤持續突出右心房內1.2公分深和2.4公分寬。食道心臟超音波發現此心房中膈瘤的大小和形狀在整個心臟收縮舒張週期並不會改變,因此分類為原發性IA型心房中膈瘤,同時並未在此病患身上發現血栓或血液分流。經過了三年追蹤,胸前心臟超音波和食道心臟超音波發現此心房中膈瘤似乎並未改變,但是左心房擴大,內徑從35mm逐漸增大到42mm。 結論:若發現心房中膈瘤應仔細辨識是否併發有二尖瓣脫垂,三尖瓣脫垂,和心房中膈缺損。在心房中膈瘤病患若有無法解釋的周邊血管或腦部血管栓塞,應給予抗凝血劑治療,若是明顯發現血液分流應考慮給予手術修補。在不明確的情況下,食道心臟超音波可輔助胸前心臟超音波診斷。對於心房中膈瘤的自然歷程和闡明任何相關的異常對心臟的影響仍需進一步研究觀察。 |
英文摘要 | Background. Primary atrial septal aneurysm is a disorder of congenital redundancy of endocardial tissue caused by connective tissue defect. In the literature, the incidence of adult primary atrial septal aneurysm is around 1%. It is asymptomatic in most patients. The most common symptom is palpitation. In the absence of interatrial shunt, primary atrial septal aneurysm does not cause any hemodynamic disturbance. However, an association between atrial septal aneurysm and stroke has been reported. Methods and Results. A 20-year-old male patient was said to have a heart murmur. Transthoracic echocardiography performed at our hospital revealed an atrial septal aneurysm, 1.2 cm in depth and 2.4 cm in width, protruding into the right atrium. The size and shape of the aneurysm did not change throughout the whole cardiac cycle, and primary type IA aneurysm was impressed. There was no thrombus in the aneurysm or presence of interatrial shunt. After a three-year follow-up, both the transthoracic and transesophageal echocardiogram showed no change in the atrial septal aneurysm; and the left atrial diameter had enlarged from 35 mm to 42 mm. Conclusion. These should be careful identification if there are mitral valve prolapse, tricuspid valve prolapase and atrial septal defect complicating an atrial septal aneurysm. Atrial septal aneurysms in patients with unexplained peripheral or cerebrovascular events are an indication for anti-coagulation therapy and possible surgical repair if shunting is demonstrated. Transesophageal echocardiography may be used as an important adjunct to transthoracic echocardiogram in less obvious cases. Further studies are necessary to determine the natural course and identify any associated disorders in cases of atrial septal aneurysm. |
本系統中英文摘要資訊取自各篇刊載內容。