Recurrent severe acute pulmonary edema caused by transient left ventricular insufficiency with mitral regurgitation related to severe coronary artery spasm.
Recurrent severe acute pulmonary edema caused by transient left ventricular insufficiency with mitral regurgitation related to severe coronary artery spasm.
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由短暂的左心室功能不全和与严重冠状动脉痉挛相关的二尖瓣关闭不全引起的反复严重急性肺水肿。
DOI：
10.1161/circheartfailure.109.921957
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
J. Figueras
中科院分区：
文献类型：
--
作者：
Ó. Alcalde;E. Domingo;J. Figueras
患者为64岁糖尿病合并血脂异常女性，过去4个月有3次急性肺水肿病史，无器质性心脏病证据。她患有垂体功能减退症，并给予左甲状腺素和去氨加压素治疗。1年前有不典型胸痛，但2次运动负荷试验阴性。在过去的4个月里，她因休息时突发性严重呼吸困难入院3次，无胸痛，因严重急性肺水肿需要气管插管。基础体格检查正常。心电图和系列肌钙蛋白水平正常。临床治疗早期拔管成功。静息时超声心动图（echo）完全正常，左心室收缩和舒张功能正常，无瓣膜反流。冠状动脉造影显示冠状动脉正常，左室整体和局部收缩运动正常。胸腹电脑断层扫描正常；排除了肺血栓栓塞、主动脉疾病和肾上肿瘤。肺活检也正常。实验室检查包括血红蛋白、电解质、自身抗体、儿茶酚胺和甲状腺激素也正常。动态心电图和遥测没有发现心律失常。门控单光子发射计算机断层扫描和应力回波显示缺血为阴性。大多数……
A 64-year-old diabetic and dyslipidemic woman was admitted to our hospital with a history of 3 episodes of acute pulmonary edema in the past 4 months, without evidence of organic heart disease. She was affected by a hypopituitarism and was treated with levothyroxine and desmopressin. She had atypical chest pain 1 year before, but 2 exercise stress tests were negative. In the past 4 months, she had been admitted 3 times for severe dyspnea at rest of sudden onset without chest pain, requiring endotracheal intubation because of severe acute pulmonary edema. Basal physical examination was normal. ECGs and serial troponin levels were normal. Clinical treatment was successful with early extubation. Echocardiography (echo) at rest was completely normal with normal left ventricular systolic and diastolic function and no valvular regurgitations. Coronary angiography revealed normal coronary arteries and normal global and regional left ventricular systolic motion. Thoracoabdominal computerized tomography was normal; and pulmonary thromboembolism, aortic disease, and suprarenal tumor were ruled out. Pulmonary biopsy also was normal. Laboratory tests including hemoglobin, electrolytes, autoantibodies, catecholamine, and thyroid hormones were also normal. Holter and telemetry did not reveal arrhythmias. Gated single-photon emission computed tomography and stress echo were negative for ischemia. Most of …