近期和推测性远程心肌创伤:病例系列

Zhijuang Lu, Xiaocong Zhang, Yanling Huang, Jia Song, Chaoqun Zhang, Qiang Wang, Handong Wu, Xinsheng Huang
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引用次数: 0

摘要

心脏钝挫伤在临床上表现为一系列严重程度不同的损伤。然而,远程心肌外伤并发症的诊断往往具有挑战性,尤其是当患者忘记提及远程胸部外伤史时。 在这里,我们将介绍一位近期经历过外伤性心肌离断和室间隔破裂的患者,以及三位表现出模拟双腔左心室的患者,这表明之前的远端心肌外伤可能与心肌离断撕裂有关。 近期严重心肌损伤的患者可通过心脏成像检查出来。然而,被遗忘的远端心肌创伤会导致不良的心肌重塑、心力衰竭和心律失常。长期的心肌重塑会掩盖最初的心肌成像特征,给解释带来挑战。我们的病例系列表明,远端心肌创伤在临床实践中可能比通常认为的更为普遍。
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Recent and Speculative Remote Myocardial Trauma: A Case Series
Cardiac blunt trauma clinically presents as a spectrum of injuries of varying severity. However, the diagnosis of complications of remote myocardial trauma is often challenging, especially if the patient forgets to mention a remote history of chest trauma. Here, we present a patient who recently experienced traumatic myocardial dissection and interventricular septal rupture, alongside three patients exhibiting a mimic double-chambered left ventricle, indicative of prior remote myocardial trauma potentially associated with the myocardial dissecting tear. Patients with recent severe myocardial injury are detectable through cardiac imaging. However, forgotten remote myocardial trauma can lead to adverse myocardial remodeling, heart failure, and arrhythmias. Long-term myocardial remodeling can obscure initial myocardial imaging characteristics, posing challenges in interpretation. Our case series suggests remote myocardial trauma may be more prevalent than commonly thought in clinical practice.
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