左心室中部肥厚合并二尖瓣冗长致左室流出道梗阻——病例报告与文献复习

摘要

Objective:To investigate the etiology,manifestations and the progress regarding the diagnosis and treatment for left ventricular outflow tract obstruction.Methods:Diagnosis and treatment of one case with mid-ventricular hypertrophy complicated with the lengthy of mitral valve leaflets lead to dynamic left ventricnlar outflow tract obstruction was followed up and reviewed with related literatures.Resuhs:The etiology of ventricular outflow tract obstruction was complex and the incidence was rather high.Transthoracic two-dimensional exercise echocardiography with transesophageal echocardiography analysis is the most effective non-invasive screening and prognostic predictive tool for left ventricular outflow tract obstruction.Conclusions:It is mandatory to selectively conduct multiple imaging examinations which mainly include exercise echocardiography and selectively left ventriculography in order to successfully improve the diagnosis of left ventricular outflow tract obstruction.%目的:探讨左室流出道梗阻的病因分类、临床表现和诊治进展.方法:对1例左心室中部肥厚合并二尖瓣前叶冗长致隐匿性左室流出道梗阻患者的诊治过程进行全程追踪随访,结合复习相关文献.结果:左室流出道梗阻病因复杂,发生率较高；超声心动图运动试验结合经食道超声探查是左室流出道梗阻最有效的无创筛查和随访评价手段,必要时左心室造影和测压可进一步明确诊断.结论:对左心室肥厚患者常规开展运动超声心动图、必要时左心室造影等多种影像学检查可以有效提高左室流出道梗阻及其病因的诊断正确率.