多年來, 許多醫師及病友們, 常以為漏斗胸只是外觀的問題, 最近我與心臟科醫師合作研究,發現許多廿多歲的年輕漏斗胸病友們心臟已有缺血性變化及心右側傳導束阻斷; 其實在1998著名的醫學雜誌Circulation 中已有德國的一篇病例報告. 僅摘譯如下:
Circulation. 1998;98:605-606
漏斗胸合併右側臥時心肌下缺氧
Pectus Excavatum With Inferior Ischemia in Right Lateral Position
Thomas A. Heitzer, MD; ; Helmut Wollschläger, MD
From the Medizinische Klinik III, Kardiologie, Universität Freiburg, Germany.
Correspondence to Thomas Heitzer, MD, Universitätskrankenhaus Eppendorf, Abteilung für Kardiologie, Martinistr 52, 20246 Hamburg, FRG.
一56歲漏斗胸之女性近兩年來右側臥時有漸漸加重的胸痛. 心電圖在右側臥時呈現ST段升高,但仰臥時則恢復正常. 胸部電腦斷層顯示漏斗胸嚴重胸骨凹陷,壓迫至上行段主動脈. 心冠狀動脈造影顯示仰臥時正常, 但右側臥時則呈現心臟右冠狀動脈近端被壓迫. 手術治療後, 病人不再有心絞痛.
A 56-year-old woman with pectus excavatum presented with a 2-year history of increasing chest pain only while she was lying on her right side. The ECG showed ST-segment elevation in inferior leads (A) when the patient was in the right lateral position and became normal when she turned onto her back. A CT of the thorax (B) showed the funnel-chest deformity and severe sternal depression, with close contact to the proximal part of the ascending aorta. Coronary angiography showed no coronary artery disease or any abnormality in supine position (D), but revealed proximal compression of the right coronary artery only when the patient lay on her right side (C).
Surgical treatment with repair of the chest deformity was successfully performed and made the patient angina free.
Circulation. 1998;98:605-606
漏斗胸合併右側臥時心肌下缺氧
Pectus Excavatum With Inferior Ischemia in Right Lateral Position
Thomas A. Heitzer, MD; ; Helmut Wollschläger, MD
From the Medizinische Klinik III, Kardiologie, Universität Freiburg, Germany.
Correspondence to Thomas Heitzer, MD, Universitätskrankenhaus Eppendorf, Abteilung für Kardiologie, Martinistr 52, 20246 Hamburg, FRG.
一56歲漏斗胸之女性近兩年來右側臥時有漸漸加重的胸痛. 心電圖在右側臥時呈現ST段升高,但仰臥時則恢復正常. 胸部電腦斷層顯示漏斗胸嚴重胸骨凹陷,壓迫至上行段主動脈. 心冠狀動脈造影顯示仰臥時正常, 但右側臥時則呈現心臟右冠狀動脈近端被壓迫. 手術治療後, 病人不再有心絞痛.
A 56-year-old woman with pectus excavatum presented with a 2-year history of increasing chest pain only while she was lying on her right side. The ECG showed ST-segment elevation in inferior leads (A) when the patient was in the right lateral position and became normal when she turned onto her back. A CT of the thorax (B) showed the funnel-chest deformity and severe sternal depression, with close contact to the proximal part of the ascending aorta. Coronary angiography showed no coronary artery disease or any abnormality in supine position (D), but revealed proximal compression of the right coronary artery only when the patient lay on her right side (C).
Surgical treatment with repair of the chest deformity was successfully performed and made the patient angina free.
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