年轻女性心源性晕厥的窦房结疾病

E. O. Olalekan, I. Iseko, A. E. Edafe, I. O. Awofisoye, O. Anya
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摘要

窦房结功能障碍(SND)的特点是窦房结和/或相邻心房组织病变,由于各种原因导致心率的产生与身体生理需要不相称。SND是一种常见于高龄人群的疾病,平均年龄为68岁,很少见于年轻人。做出诊断需要症状的出现与异常的心电图(ECG)结果相吻合,SND的症状是非特异性的。关于这种情况在年轻人中的报道有限,现有的报告显示,大多数SND病例发生在有潜在心脏缺陷的年轻人和儿童中,主要发生在男性中。本报告描述了一个不寻常的“窦房结疾病”的表现,年轻的白人女性没有潜在的心脏异常,表现为晕厥和窦性心动过缓。一位36岁的白人女性到我们医院就诊,主诉有短暂的意识丧失,伴有间断性心悸,无心血管疾病背景。静息12导联心电图显示心动过缓,而24小时动态心电图显示阶段性心动过缓,“室上性心动过速”和伴有症状的心动过速-心动过缓。诊断为SND,并提供了永久起搏器,但她和她的配偶选择在她的祖国进行手术。“窦房结病”是老年人的一种疾病,可以在没有潜在心脏缺陷的年轻人身上发现,也可以在不明原因的晕厥患者身上怀疑。
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SINUS NODE DISEASE IN A YOUNG FEMALE WITH CARDIOGENIC SYNCOPE
Sinus node dysfunction (SND) is characterized by disease of the sinus node and/or contiguous atrial tissue resulting in the generation of heart rate that is not commensurate with the physiologic need of the body due to various causes. SND is an ailment commonly found in the advanced age group, with a mean age of 68 years, and is rarely found in the young. Making a diagnosis requires the presence of symptoms to coincide with the abnormal electrocardiographic (ECG) findings, and the symptoms of SND are non-specific. There is a limited report of this condition in the young, and available reports show that most cases of SND occur in the young and children with underlying heart defects and mostly in males. The report describes an unusual presentation of ‘sinus node disease’ in a young Caucasian female with no underlying cardiac abnormalities that presented with syncope and sinus bradycardia. A 36-year-old Caucasian female presented to our facility with complaints of recurrent episodes of a brief period of loss of consciousness associated with intermittent palpitations and no background cardiovascular disease. Rest 12-lead ECG showed bradycardia, while a 24-hour Holter ECG showed periods of bradycardia, ‘supraventricular tachycardia’, and tachycardia- bradycardia occurring with symptoms. A diagnosis of SND was made and a permanent pacemaker was offered, but she and her spouse opted to have the procedure done in her home country. ‘Sinus node disease’ through an ailment of the aged can be found in the young without underlying cardiac defects and can be suspected in people with unexplained syncope.
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