Cardiac sarcoidosis mimicking right ventricular dysplasia.
Cardiac sarcoidosis mimicking right ventricular dysplasia.
复制标题
心脏结节病酷似右心室发育不良。
DOI：
10.1253/circj.67.169
复制
发表时间：
2003
期刊：
影响因子：
--
通讯作者：
M. Nakagawa
中科院分区：
文献类型：
--
作者：
J. Shiraishi;T. Tatsumi;K. Shimoo;A. Katsume;H. Mani;M. Kobara;T. Shirayama;A. Azuma;M. Nakagawa
一名59岁的妇女皮肤结节病入院评估完全房室传导阻滞。横断面超声心动图显示右心室心尖游离壁变薄，运动障碍，右心室扩张。铊-201心肌显像显示正态分布。镓-67和锝-99m焦磷酸盐显像显示心肌中没有异常摄取。右心室造影显示室腔扩张和心尖游离壁运动障碍，而左心室造影显示运动正常，模仿右心室发育不良。心脏结节病是在右心室肌内膜活检标本检查中诊断的。植入永久性起搏器以管理完全性房室传导阻滞。类固醇治疗后，心电图显示一度房室传导阻滞，超声心动图显示右心室腔扩张改善。类似右心室发育不良的心脏结节病的报告极为罕见，正如本例所示，右心室受累可能是其表现之一。
A 59-year-old woman with skin sarcoidosis was admitted to hospital for assessment of complete atrioventricular block. Cross-sectional echocardiography showed that the apical free wall of the right ventricle was thin and dyskinetic with dilation of the right ventricle. Thallium-201 myocardial imaging revealed a normal distribution. Both gallium-67 and technetium-99m pyrophosphate scintigraphy revealed no abnormal uptake in the myocardium. Right ventriculography showed chamber dilation and dyskinesis of the apical free wall, whereas left ventriculography showed normokinesis, mimicking right ventricular dysplasia. Cardiac sarcoidosis was diagnosed on examination of an endomyocardial biopsy specimen from the right ventricle. A permanent pacemaker was implanted to manage the complete atrioventricular block. After steroid treatment, electrocardiography showed first-degree atrioventricular block and echocardiography revealed an improvement in the right ventricular chamber dilation. Reports of cardiac sarcoidosis mimicking right ventricular dysplasia are extremely rare and as this case shows, right ventricular involvement may be one of its manifestations.