慢性活跃心肌炎呈现为隔离心阻塞:一个病例报告
Kazuhiro Asano1, Masahiko Noguchi1, Kisaki Amemiya2
1Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32 Todaijima, Urayasu, Chiba 279-0001, Japan.
European heart journal. Case reports
|October 6, 2025
概括
隔离性心房静脉 (AV) 阻塞可能是慢性活跃心肌炎的罕见症状. 通过心脏内膜活检及长期监测进行早期诊断对于管理这种情况至关重要.
科学领域:
- 心脏病学 心脏病学
- 病理学 病理学 病理学
- 免疫学 免疫学 免疫学
背景情况:
- 心房 (AV) 阻塞在急性心肌炎中很常见,但在慢性活性心肌炎中很少作为孤立的发现.
- 慢性活跃心肌炎是一种不常见的疾病,预后可能不佳.
研究的目的:
- 报告一种罕见的慢性活跃心肌炎病例,仅呈现为孤立的AV阻塞.
- 为了强调在无法解释的 AV 阻塞的情况下考虑心肌炎的重要性.
主要方法:
- 一个51岁的女性患有完整的AV阻塞的案例展示.
- 诊断工作包括心声回声检查,I型热血素水平,18F-FDG-PET/CT,心脏内膜活检.
- 长期跟踪超过2年.
主要成果:
- 患者呈现出完全的AV阻塞和保存的心脏功能,与持续升高的托罗邦素I.
- 内心肌瘤活检证实了慢性活性心肌炎与炎症透,缩和纤维化.
- 尽管最初情况有所改善,PET发现减少,但亚临床炎症仍然存在,由持续的FDG-PET/CT摄入量和托罗邦素I升高表明.
结论:
- 心室膜阻塞可能是慢性活跃心肌炎的临床表现,即使没有典型的炎症症状或缩功能障碍.
- 内心肌活检对于诊断这种病例至关重要.
- 由于持续的亚临床炎症可能导致不良结果的风险,需要进行长期的随访.
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