急性下壁心肌梗死后二尖瓣前叶假性脱垂一例  

Anterior Mitral Valve Leaflet“Prolapse”After Inferior Myocardial Infarction:A Case Report of Ischemic Mitral Regurgitation

作　　者：徐晗[1] 伏蕊[1] 宋卫华[1] 高国峰[1] 吴元[1] 窦克非[1] XU Han;FU Rui;SONG Wei-hua;GAO Guo-feng;WU Yuan;DOU Ke-fei(Department of Cardiology,Fuwai Hospital&National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院冠心病中心,北京市100037

出　　处：《中国分子心脏病学杂志》2020年第6期3670-3672,共3页Molecular Cardiology of China

基　　金：国家重点研发计划(2018YFC1315602)。

摘　　要：35岁男性因胸痛18小时急诊入院,急诊造影提示右冠状动脉闭塞,光学相干成像检查提示斑块侵蚀,术后药物治疗期间超声检查发现二尖瓣中大量反流合并"脱垂"。进一步行磁共振检查明确二尖瓣乳头肌及瓣叶结构完整,提示二尖瓣"脱垂"为功能性二尖瓣反流造成。心脏团队建议首选药物治疗并长期随诊,必要时进行二尖瓣修复治疗。超声提示患者功能性二尖瓣反流情况持续,随访提示患者恢复良好至今没有发生并发症。A 35-year-old man was admitted to emergency department for chest pain.He had presented with chest pain 18 hours earlier.Angiography revealed occlusion of right coronary artery.Optical coherence tomography of the right coronary demonstrated an erosion plaque and no stent was planted.Echocardiogram showed anterior mitral leaflet"prolapse"with moderate-to-severe mitral regurgitation.Further cardiac magnetic resonance image confirmed the integrity of mitral papillary muscle and mitral leaflet which meant the mitral leaflet prolapse was due to functional mitral regurgitation.The heart team advised medication treatment as a first choice therapy and mitral valve repair surgery should be considered when necessary.The follow-up echocardiogram showed continued anterior mitral leaflet overriding with moderate regurgitation.The patient made a good recovery following cardiac rehabilitation and no major adverse event occurred so far.

关 键 词：冠心病 心肌梗死 二尖瓣脱垂 功能性二尖瓣反流 缺血性二尖瓣反流 

分 类 号：R542.22[医药卫生—心血管疾病] R542.51[医药卫生—内科学]