不紧凑的左心室心肌:临床实践中罕见疾病的一个例子

О. В. Гайсёнок, Татьяна Борисовна Гребенюк, П. А. Курносов, И. В. Шаталова
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引用次数: 1

摘要

目的:描述一种罕见的心脏疾病——左心室不压实症的临床病例。材料和方法。病人G, 1948年,因血压波动、心力衰竭、心脏不适、头晕、头痛等主诉而住院。患者接受了以下常规检查:血液常规及生化检查、心电图、动态心电图监测、跑步机试验、超声心动图、颈部血管彩色双工扫描、甲状腺及肾脏超声、胸部x线片。结果。根据病史,主诉,疾病的临床表现,客观和仪器检查资料,作出临床诊断:左心室不致密。超声心动图检查是验证诊断的主要诊断方法之一:两层心肌的下根尖部分的结构,存在非致密层(有表间破裂),与致密层的比例为2:1;左心房的一小部分延伸;左室上下段轻度运动减退,LVEF未下降(PV = 73%)。结论。这个临床病例很有趣,因为在临床实践中超声波检查心脏的时代,这种疾病被掩盖在风湿病的幌子下,现在已经在参考超声心动图研究中被诊断出来。尽管这种疾病属于罕见的疾病,但它可以发生在任何年龄组,并且通常是无症状的。
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НЕКОМПАКТНЫЙ МИОКАРД ЛЕВОГО ЖЕЛУДОЧКА: ПРИМЕР РЕДКОГО ЗАБОЛЕВАНИЯ В КЛИНИЧЕСКОЙ ПРАКТИКЕ
Objective: to describe the clinical case of a rare heart disease – left ventricular non-compaction. Materials and methods. Patient G., 1948, was hospitalized in connection with complaints of fluctuations in blood pressure, heart failure, discomfort in the heart, dizziness, headaches. The patient underwent the following general examination: general and biochemical blood tests, electrocardiography, Holter ECG monitoring, treadmill test, echocardiography, color duplex scanning of neck vessels, ultrasound of the thyroid and kidneys, chest X-ray. Results. Based on the history, complaints, clinical picture of the disease, objective and instrumental examination data, a clinical diagnosis was made: left ventricular non-compaction. One of the main diagnostic methods that allowed to verify the diagnosis was echocardiographic study: the structure of the myocardium of the lower-apical section of a two-layered one, with the presence of a noncompact layer (with intertabercular breaks), in relation to the compact as 2:1; a small extension of the left atrium; small hypokinesia in the lower-upper segment of the LV, without a decrease in the LVEF (PV = 73 %). Conclusion. This clinical case is interesting because the disease, concealed under the guise of rheumacarditis in an era when ultrasonic methods of examining the heart were not available in clinical practice, has now been diagnosed in the conduct of a reference echocardiographic study. Despite the fact that this disease belongs to rare nosology, it can occur in any age group and can often be asymptomatic.
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