초록
저자들은 교통사고 후 호흡곤란을 보이는 환자에서 경흉부 심장초음파를 통해 좌심방 압박과 압박 구조물을 우연히 확인할 수 있었고 CT를 통해 압박 구조물이 국소 낭형 하행흉부 대동맥류임을 확인할 수 있었다. 본 증례는 외상 때문에 발생한 국소 낭형 대동맥류가 좌심방을 압박하는 증례이며 대동맥류 치료 방법의 선택에 시사하는 바가 있어서 문헌고찰과 함께 보고하는 바이다.
A 78-year-old woman presented to our hospital with progressive dyspnea (NYHA class I-II) and epigastric discomfort that had developed after a traffic accident. She had a history of hypertension and cerebral infarction, but no history of cardiovascular disease. Her blood pressure was 130/70 mmHg and her heart rate was 66 beats/min and regular. The electrocardiogram showed normal sinus rhythm. The chest X-ray revealed bilateral pleural effusions. Transthoracic echocardiography (TTE) demonstrated an aneurysm of the descending thoracic aorta compressing the left atrium (LA). Left and right ventricular systolic function was preserved. Whole-body computed tomography (CT) angiography revealed that a focal 40-mm-diameter saccular aneurysm in the descending aorta at the level of T7-8, with an intramural hematoma, was compressing the LA and left pulmonary vein. After surgical management, follow-up TTE and CT showed decompression of the LA and left pulmonary vein.