摘要
To the Editor： A 43-year-old man diagnosed with dilated cardiomyopathy 6 years prior visited our institution recently because of worsened chest congestion with shortness of breath and abdominal distension. The patient had a history of diabetes. His electrocardiography （ECG） demonstrated a sinus rhythm with an mtraventricular conduction disturbance, an atypical left bundle branch block, and a QRS interval of 160 ms. Echocardiographic findings were consistent with dilated cardiomyopathy [bicentric type, Figure la], in which the left atrial diameter was 44 ram, the left ventricular end-diastolic diameter was 78 mm, and the left ventricular ejection fiaction was 30%. The final diagnosis was New York Heart Association Grade Ⅲ dilated cardiomyopathy. To achieve a good prognosis, improve exercise tolerance, and prevent sudden death, cardiac resynchronization therapy （CRT） with defibrillator implantation was advised. However, coronary sinus （CS） abnormalities were observed during the implantation operation. Therefore, it was forced to stop the operation and a cardiac computed tomography angiography （CTA） evaluation of the abnormalities was arranged.
To the Editor： A 43-year-old man diagnosed with dilated cardiomyopathy 6 years prior visited our institution recently because of worsened chest congestion with shortness of breath and abdominal distension. The patient had a history of diabetes. His electrocardiography （ECG） demonstrated a sinus rhythm with an mtraventricular conduction disturbance, an atypical left bundle branch block, and a QRS interval of 160 ms. Echocardiographic findings were consistent with dilated cardiomyopathy [bicentric type, Figure la], in which the left atrial diameter was 44 ram, the left ventricular end-diastolic diameter was 78 mm, and the left ventricular ejection fiaction was 30%. The final diagnosis was New York Heart Association Grade Ⅲ dilated cardiomyopathy. To achieve a good prognosis, improve exercise tolerance, and prevent sudden death, cardiac resynchronization therapy （CRT） with defibrillator implantation was advised. However, coronary sinus （CS） abnormalities were observed during the implantation operation. Therefore, it was forced to stop the operation and a cardiac computed tomography angiography （CTA） evaluation of the abnormalities was arranged.
作者
Li Zhang
Zi-Xian Chen
Wei Tian
Xin-Ling Yang
Shun-Lin Guo
Li Zhang;Zi-Xian Chen;Wei Tian;Xin-Ling Yang;Shun-Lin Guo(Department of the First Clinical Medical College,Lanzhou University,Lanzhou,Gansu 730000,China;Department of Radiology,The First Hospital of Lanzhou University,Lanzhou,Gansu 730000,China;Department of Magnetic Resonance Imaging,Cardiovascular Imaging and Intervention Center,Fuwai Hospital,State Key Laboratory of Cardiovascular Disease Beijing 100037,China)
基金
This work was-partly supported by a grant of the First Hospital of Lanzhou University Science Foundation （No. ldyyyn 2015-06）.
