心脏损伤导致创伤性心室隔膜断裂与右心室伪动脉瘤
Mahima Tyagi1, Matthew Shotwell1, Amelia E Power1
1Division of Cardiology, University of Louisville, Louisville, Kentucky, USA.
JACC. Case reports
|September 20, 2025
概括
心室隔膜破裂 (VSR) 和右心室伪动脉瘤是不心脏损伤 (BCI) 的罕见并发症. 连续成像对于诊断和管理创伤后这些可能致命的疾病至关重要.
科学领域:
- 心脏病学 心脏病学
- 创伤外科 手术 创伤外科
- 医疗成像医学成像
背景情况:
- 心室隔膜破裂 (VSR) 是心脏损伤 (BCI) 的罕见,可能致命的后果.
- 同时的右心室 (RV) 伪动脉瘤形成甚至更罕见.
- 之前没有报道BCI后VSR和RV伪动脉瘤的同时发生.
研究的目的:
- 在BCI后报告一种罕见的同时出现VSR和RV伪动脉瘤的病例.
- 突出多模式成像在诊断和管理这些并发症的重要性.
- 为了强调连续成像在突发心脏创伤中的作用.
主要方法:
- 一名63岁的男子在发生机动车祸后BCI后出现了VSR和三角损伤.
- 最初的手术修复被拒绝;一个月后,成像显示了持续的VSR和新的VR伪动脉瘤.
- 穿皮关闭是不可能的,开放式手术修复再次被拒绝.
主要成果:
- 该患者出现了严重的心力衰竭症状,原因是持续的VSR和新发育的RV伪动脉瘤.
- 多模式成像提供了对解剖缺陷和组织特征的全面评估.
- 管理决策的指导是成像发现,患者的病情和偏好.
结论:
- 在BCI后的VSR是由于急性机械力或延迟亡造成的.
- RV伪动脉瘤可以发展为延迟的并发症,可能是由于炎症性缩.
- 早期识别和串行成像在形心脏创伤中至关重要;对于重大缺陷,建议进行手术修复.
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