Constrictive pericarditis developed after childhood repair of ventricular septal defect
Constrictive pericarditis developed after childhood repair of ventricular septal defect
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儿童期室间隔缺损修复后发生缩窄性心包炎
作者：
Hirofumi Saiki;S. Masutani;M. Tamura;H. Senzaki
患者是一名18岁的男性，他在2岁时接受了室间隔缺损的手术。患者在术后长期平稳后因晕厥而紧急住院，并被诊断为心房扑动。超声心动图显示心室运动不良，双心房明显扩张。心房扑动终止后，心室运动明显改善；然而，心力衰竭几乎没有改善。虽然我们怀疑是缩窄性心包炎，但在计算机断层扫描上观察到的钙化过于局限，无法完全解释严重舒张功能障碍的原因。根据二尖瓣环状组织多普勒成像波形，我们强烈相信缩窄性心包炎的潜在生理学。心包脱屑明显改善心衰症状。本病例强调缩窄性心包炎可能是先天性心脏手术后晚期危及生命的并发症。同时强调了超声心动图功能评估对确定影像学与临床症状之间的因果关系的重要性。
The patient was an 18‐year‐old man who had undergone surgical closure of ventricular septal defect at the age of 2 years. The patient was urgently hospitalized due to syncope after longstanding uneventful postoperative course, and diagnosed with atrial flutter. Echocardiography showed poor ventricular motion and markedly dilated both atriums. After termination of atrial flutter, ventricular motion improved remarkably; however, there was little improvement in heart failure. Although we suspected constrictive pericarditis, calcification observed on computed tomography was too localized to fully explain the cause of severe diastolic dysfunction. Based on the waveform of mitral annular tissue Doppler imaging, we were strongly convinced of the underlying physiology of constrictive pericarditis. Pericardial decortications markedly improved heart failure symptoms. This case emphasizes that constrictive pericarditis could be a life‐threatening complication in the remote phase after congenital heart surgery. It also emphasizes the importance of functional assessment by echocardiography to identify the cause–effect relation between imaging and clinical symptoms.
短期心动过速引起的心脏抑制和血管紧张素 II 协同加剧舒张期僵硬度。
影响因子：
20.1
作者：
Senzaki,H;Gluzband,YA;Pak,PH;Crow,MT;Janicki,JS;Kass,DA
通讯作者：
Kass,DA