- 期刊
Left Ventricular Aneurysm with Normal Coronary Angiogram: A Case Report and Literature Review
正常冠狀動脈之左心室瘤－病例報告及文獻回顧
摘要
大多數左心室瘤都是發生在冠狀動脈疾病因動脈粥狀硬化堵塞引發之心肌梗塞後的併發症。然而偶而也有左心室瘤發生在正常冠狀動脈之狀況，例如：擴張性心肌病變、肥厚性心肌病變、Chagas's disease、類肉瘤病、胸部外傷和先天性異常疾病：但一般並不常見。在此我們報告一位53歲男性其心臟超音波檢查無意今現有後壁左心室瘤合併左心室收縮功能衰竭且其壓力性鉈－201核子醫學檢查呈現下側壁及心尖部位有不可逆的血液灌流缺陷，而冠狀動脈血管攝影檢查結果是正常冠狀動脈。這位病人目前已在我們內科門診追蹤了40個月，情況良好。由血栓造成之下後壁心肌梗塞而後自行再灌流可能是其病因。
並列摘要
Most left ventricular aneurysms (LVA) develop in the atherosclerotic occlusive coronary artery disease following a transmural myocardial infarction. However, occasionally, LVA associated with normal coronary artery was found as well in dilated cardiomyopathy, hypertrophic cardiomyopathy, Chagas's disease, sarcoidosis, chest trauma, and congenital malformation. We report a 53-year-old male who had systolic heart failure owing to a posterior wall aneurysm of the left ventricle, which was found unintentionally during echocardiographic examination. Subsequent stress thallium scan revealed irreversible defects in the inferolateral wall and apex, and coronary angiography showed normal coronary arteries. The patient remained well under medical control for a follow-up period of 40 months. Previously undiagnosed inferoposterior wall myocardial infarction caused by thromboembolism with spontaneous reperfusion may be considered in this patient.
延伸閱讀
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