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原发性肺动脉高压误诊为卵圆孔未闭1例

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摘要 1 病史资料 患者女,9岁,因"呼吸道感染后胸闷,胸痛4天"入院.入院体查:发育迟缓,口唇无发绀,可见剑突下抬举性心脏搏动,心率94次/分,律齐,心脏叩诊心界向右扩大,可于胸骨左缘第二肋间闻及2/6收缩期杂音,肺动脉瓣第二心音亢进.入院检查:①胸片:右房,右室增大,肺动脉高压,可见肺门截断征;②心脏彩超回报:右心增大,肺动脉增宽,(PA内径21mm,AO根部内径14mm)肺动脉高压,卵圆孔未闭,三尖瓣关闭不全.③ECG:窦性心律,右室肥大.右心造影,肺动脉测压结果:主肺动脉平均压52mmHg,右心室压27mmHg,肺动脉楔入压12mmHg,吸氧15分钟后测肺动脉平均压51mmHg,考虑特发性肺动脉高压(重度)可能性大,入院胸闷,口唇紫绀时测动脉血气,PO2 43mmHg.
作者 李涛 刘建新
出处 《中国医药指南》 2012年第8期577-578,共2页 Guide of China Medicine
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