PDF(Pubmed)
Abstract：
UNASSIGNED: The coexistence of rheumatic heart disease (RHD) and pulmonary arteriovenous malformation (PAVM) is a rare clinical scenario that poses diagnostic and therapeutic challenges. This case report explores the clinical presentation, diagnostic journey, and multidisciplinary management of a patient presenting with both conditions.
UNASSIGNED: A 47-year-old female with a history of RHD presented with symptoms of dyspnoea on exertion and cyanosis, suggestive of both cardiac involvement and pulmonary involvement. Subsequent investigations involving imaging, echocardiography, and invasive pulmonary angiography revealed the coexistence of RHD and multiple PAVM in the patient\'s left lower lobe of the lung. The patient underwent a tailored treatment plan, initially involving percutaneous mitral balloon valvuloplasty for RHD, followed by a staged procedure of transcatheter PAVM closure with Amplatzer™ Vascular Plug II performed 1 month later. Her saturation normalized following the intervention. The patient\'s progress was monitored closely, with adjustments made to the treatment plan based on evolving clinical scenarios. The patient remained well in short-term follow-up.
UNASSIGNED: This case highlights the complexity of managing patients having two diverse conditions RHD and PAVM coexisting together, thus emphasizing the importance of a multidisciplinary approach. The unique intersection of cardiac and pulmonary pathologies necessitates careful consideration of diagnostic nuances and tailored treatment strategies. Lessons learned from this case offer valuable insights for clinicians encountering similar scenarios and underscore the significance of individualized, patient-centred care in optimizing outcomes for those with dual pathologies.
UNASSIGNED: A 47-year-old female with a history of RHD presented with symptoms of dyspnoea on exertion and cyanosis, suggestive of both cardiac involvement and pulmonary involvement. Subsequent investigations involving imaging, echocardiography, and invasive pulmonary angiography revealed the coexistence of RHD and multiple PAVM in the patient\'s left lower lobe of the lung. The patient underwent a tailored treatment plan, initially involving percutaneous mitral balloon valvuloplasty for RHD, followed by a staged procedure of transcatheter PAVM closure with Amplatzer™ Vascular Plug II performed 1 month later. Her saturation normalized following the intervention. The patient\'s progress was monitored closely, with adjustments made to the treatment plan based on evolving clinical scenarios. The patient remained well in short-term follow-up.
UNASSIGNED: This case highlights the complexity of managing patients having two diverse conditions RHD and PAVM coexisting together, thus emphasizing the importance of a multidisciplinary approach. The unique intersection of cardiac and pulmonary pathologies necessitates careful consideration of diagnostic nuances and tailored treatment strategies. Lessons learned from this case offer valuable insights for clinicians encountering similar scenarios and underscore the significance of individualized, patient-centred care in optimizing outcomes for those with dual pathologies.
摘要：
■风湿性心脏病（RHD）和肺动静脉畸形（PAVM）并存是一种罕见的临床情况，对诊断和治疗提出了挑战。本病例报告探讨了临床表现，诊断旅程，以及对同时患有这两种疾病的患者进行多学科管理。
一名47岁女性，有RHD病史，表现为劳累时呼吸困难和发紫的症状，提示心脏受累和肺部受累。随后涉及成像的调查，超声心动图,有创肺动脉造影显示患者左肺下叶RHD和多发性PAVM共存。患者接受了量身定制的治疗计划，最初涉及RHD的经皮二尖瓣球囊瓣膜成形术，1个月后,采用Amplatzer™血管栓塞II进行经导管PAVM封堵术。干预后她的饱和度恢复正常。病人的进展受到密切监测，根据不断发展的临床情况对治疗计划进行调整。患者在短期随访中仍然良好。
■此案例突出了管理RHD和PAVM并存的两种不同疾病的患者的复杂性，从而强调多学科方法的重要性。心脏和肺部病理的独特交集需要仔细考虑诊断细微差别和量身定制的治疗策略。从这个案例中吸取的经验教训为遇到类似情况的临床医生提供了宝贵的见解，并强调了个性化的重要性，以患者为中心的护理可优化双重病理患者的预后。
一名47岁女性，有RHD病史，表现为劳累时呼吸困难和发紫的症状，提示心脏受累和肺部受累。随后涉及成像的调查，超声心动图,有创肺动脉造影显示患者左肺下叶RHD和多发性PAVM共存。患者接受了量身定制的治疗计划，最初涉及RHD的经皮二尖瓣球囊瓣膜成形术，1个月后,采用Amplatzer™血管栓塞II进行经导管PAVM封堵术。干预后她的饱和度恢复正常。病人的进展受到密切监测，根据不断发展的临床情况对治疗计划进行调整。患者在短期随访中仍然良好。
■此案例突出了管理RHD和PAVM并存的两种不同疾病的患者的复杂性，从而强调多学科方法的重要性。心脏和肺部病理的独特交集需要仔细考虑诊断细微差别和量身定制的治疗策略。从这个案例中吸取的经验教训为遇到类似情况的临床医生提供了宝贵的见解，并强调了个性化的重要性，以患者为中心的护理可优化双重病理患者的预后。
