COVID-19感染背景下Lutembatcher综合征的加重:罕见病例报告

A. W. Nugraha, Y. Azmi, T. T. E. Lusida, Lisca Namretta, Nida A. Suyani, F. S. Laitupa
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引用次数: 0

摘要

Lutembatcher综合征是一种罕见的心脏疾病,其特征是房间隔缺损(ASD;先天性或医源性)和二尖瓣狭窄(多发性硬化症;先天性或后天)。一般而言,Lutembatcher综合征患者和成人先天性心脏病(ACHD)患者在伴有2019冠状病毒病(COVID-19)时可能处于高危状态。由于没有关于COVID-19对ACHD影响的已发表研究,因此对这部分患者的管理策略知之甚少。在此,我们报告一位年轻的成年女性,表现为腹部不适,腿部肿胀,发烧,咳嗽和呼吸困难。患者五年前出现心悸和运动不耐受,但没有引起注意。超声心动图显示大面积继发性ASD伴严重多发性硬化症(威尔金斯评分为8分),鼻咽拭子确诊为SARS-COV-2感染。患者被诊断为Lutembacher综合征和COVID-19。加强治疗,缓解心力衰竭症状,治疗COVID-19肺炎。Lutembatcher综合征患者感染COVID-19并表现为严重感染的风险较高。因此,在大流行期间需要确定ACHD患者的感染风险和COVID-19的严重程度。
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The Exacerbation of Lutembatcher Syndrome in The Setting of COVID-19 infection: A Rare Case Report
Lutembatcher syndrome is a rare cardiac condition characterized by a combination of the atrial septal defect (ASD; congenital or iatrogenic) and mitral stenosis (MS; congenital or acquired). Patients with Lutembatcher syndrome and adults with congenital heart disease (ACHD) in general may be at high risk when accompanied by coronavirus disease 2019 (COVID-19). Since there is no published study on the impact of COVID-19 on ACHD, little is known about management strategies in this subset of patients. Herein, we report a young adult female presented with abdominal discomfort, swollen legs, fever, cough, and dyspnea. The patient had developed palpitation and exercise intolerance five years ago but paid it no attention. Echocardiography revealed large secundum type ASD with severe MS (Wilkins score of eight) and a nasopharyngeal swab confirmed SARS-COV-2 infection. The patient was diagnosed with Lutembacher syndrome and COVID-19. Intensive treatment was given to relieve symptoms due to heart failure and to treat COVID-19 pneumonia. Patients with Lutembatcher syndrome are at a higher risk of being infected with COVID-19 and manifest into severe infections. Therefore, determining the risk of infection and the severity of COVID-19 in ACHD patients are required during the pandemic.
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