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患者,女性,65岁。7年前发现血压高,未治。半 年前活动后胸闷气促,双下肢浮肿,近期出现夜间阵 发性呼吸困难。查体:心浊音界稍向左扩大,心尖闻 及Ⅰ~Ⅱ级收缩期杂音。临床诊断:高血压病,心衰 Ⅲ度。彩超(CDFI)检测:各瓣膜轻度返流,左室轻 度扩大,其内探及似椭圆形囊性活动肿物,大小约 43mm×18mm,清晰,壁回声较强,借5mm的蒂附着 于前间隔中部偏向心尖侧,整个囊袋飘浮在左室内,柔 顺度大,在血流的冲击下,以蒂为固定点,沿血流方 向伸展变长,与血流垂直方向的长度变短,对左室流 出道未构成梗阻,CDFI显示囊内无血流信息(图1)。 治疗3周后,心衰纠正,彩超复检,左室内淋巴管囊 肿回缩,蒂部残留一小囊泡,内存少量积液(图2)。后 经心脏造影证实。
Patient, female, 65 years old. Seven years ago found that high blood pressure, untreated. Six months ago after activities chest tightness and shortness of breath, both lower extremity edema, paroxysmal nocturnal paroxysmal dyspnea. Physical examination: heart dull voice to the left to expand slightly, apex smell and Ⅰ ~ Ⅱ systolic murmur. Clinical diagnosis: hypertension, heart failure Ⅲ degrees. Color ultrasonography (CDFI) detection: mild valvular regurgitation, mild left ventricular enlargement, the exploration and seemingly oval-shaped cystic tumor mass, the size of about 43mm × 18mm, clear, strong wall echo, by 5mm pedicle attachment Central to the apex of the anterior septum, the entire bag floating in the left ventricle, suppleness, under the impact of blood flow to pedicle fixed point, along the direction of blood flow to extend the longer, perpendicular to the blood flow length becomes shorter , Did not constitute obstruction of the left ventricular outflow tract, CDFI showed no blood flow within the capsule information (Figure 1). Three weeks after treatment, heart failure correction, color Doppler ultrasound, left ventricular lymphatic cystic retraction, pedicle remnants of a small vesicle, a small amount of memory effusion (Figure 2). After confirmed by cardiac radiography.