山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (2): 64-67.doi: 10.6040/j.issn.1673-3770.1.2021.246

• • 上一篇    下一篇

左心房增大导致吞咽困难疑似食管异物1例并文献复习

宋晴1,2,王晓勇3,贾传亮2,牟亚魁2,宋西成2   

  1. 1. 潍坊医学院 临床医学院, 山东 潍坊 261000;
    2. 青岛大学附属烟台毓璜顶医院 耳鼻咽喉头颈外科/山东省耳鼻喉疾病临床医学研究中心, 山东 烟台 264000;
    3. 烟台市烟台山医院 耳鼻咽喉科, 山东 烟台 264000
  • 发布日期:2022-04-15
  • 通讯作者: 牟亚魁. E-mail:muykmd@126.com;宋西成. E-mail:drxchsong@163.com
  • 作者简介:宋晴,王晓勇为共同第一作者
  • 基金资助:
    山东省自然科学基金(ZR2019PH113);泰山学者工程资助项目(ts20190991)

Dysphagia due to left atrial enlargement: a case report and literature review

SONG Qing1,2, WANG Xiaoyong3, JIA Chuanliang2, MOU Yakui2, SONG Xicheng2   

  1. 1. Weifang Medical University, Clinical Medical School, Weifang 261000, Shandong, China;
    2. Department of Otorhinolaryngology & Head and Neck Surgery, Yantai Yuhuangding Hospital Affiliated to Qingdao University/ Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China;
    3. Department of Otorhinolaryngology, Yantaishan Hospital of Yantai, Yantai 264000, Shandong, China
  • Published:2022-04-15

摘要: 目的 探讨左心房增大导致吞咽困难病例的临床特点并回顾分析此类患者的诊治经验。 方法 报道了1例因左心房增大导致吞咽困难患者的临床资料,并检索了近10年由左心房导致吞咽困难的相关报道。总结其临床特点、诊断及治疗方法。 结果 共纳入15篇文献,包括男7例,女8例,患者主要表现为体质量减轻、呼吸困难和声音嘶哑。胸部CT、上消化道造影和心脏超声是常用的辅助检查。有诊治资料的14例患者中,半数患者采取手术治疗,术后吞咽困难症状改善。 结论 导致吞咽困难的原因很多,由于左心房增大引起吞咽困难罕见,国内外相关报道较少,多数为个案报道。考虑此类患者年龄较大基础疾病较多,临床医生需要多方面观察、评估,采用最佳治疗方法,具体问题具体分析。

关键词: 左心房, 吞咽困难, 风湿性心脏病, 二尖瓣反流, 食管狭窄

Abstract: Objective To report and review the clinical features and treatment experienceof dysphagia caused by left atrial enlargement. Methods We examined a patient presenting with dysphagia for left atrial hypertrophy and searched for relevant reports of patients with dysphagia caused by left atrial enlargement in the past ten years. The clinical characteristics, diagnosis, and treatment of these patients were summarized. Results Fifteen articles comprising seven men and eight women were included. The patients mainly presented with lose weight、 dyspnea、 voice hoarseness. Chest CT, upper gastrointestinal angiography and ultrasonic cardiogram? are commonly adjunct examination. Of the 14 patients with available data of diagnosis and treatment diagnosis, half underwent surgical treatment and postoperative dysphagia improved. Conclusion Although dysphagia has several etiologies, dysphagia caused by left atrial hypertrophy is rare and only reported in individual cases. Therefore, clinicians need to carefully observation、evaluation and use the best way for the etiologies of dysphagia, especially in older age patients as they are more likely to have underlying chronic disease.

Key words: Left atrium, Dysphagia, Rheumatic heart disease, Mitral regurgitation, Esophageal stenosis

中图分类号: 

  • R766.9
[1] Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J]. J Am Soc Echocardiogr, 2015, 28(1): 1-39.e14. doi:10.1016/j.echo.2014.10.003.
[2] Flores Umanzor EJ, Mimbrero M, San Antonio R, et al. Giant left atrium as a rare cause of dysphagia[J]. Am J Med, 2016, 129(12): e335-e336. doi:10.1016/j.amjmed.2016.05.046.
[3] Apostolakis E, Shuhaiber JH. The surgical management of giant left atrium[J]. Eur J Cardio - Thorac Surg, 2008, 33(2): 182-190. doi:10.1016/j.ejcts.2007.11.003.
[4] Adams C, Busato GM, Chu MWA. Left atrial reduction plasty: a novel technique[J]. Ann Thorac Surg, 2012, 93(3): e77-e79. doi:10.1016/j.athoracsur.2011.11.013.
[5] Alhajiri A, Ramadan MM, Senior R. Left atrial enlargement causing dysphagia and weight loss: a rare contraindication for catheter ablation therapy in a patient with complex atrial arrhythmia[J]. Int J Cardiol, 2014, 177(3): e111-e112. doi:10.1016/j.ijcard.2014.09.084.
[6] Arifputera A, Loo G, Chang P, et al. An unusual case of dysphonia and dysphagia[J]. Singapore Med J, 2014, 55(2): e31-e33. doi:10.11622/smedj.2013212.
[7] Bugra AK, Kadirogulları E, Onan B. Reduction plasty for giant left atrium causing dysphagia: a case report[J]. Gen Thorac Cardiovasc Surg, 2021, 69(3): 546-549. doi:10.1007/s11748-020-01490-4.
[8] Frigy A. Giant left atrium causing severe dysphagia[J]. Pan Afr Med J, 2018, 29: 52. doi:10.11604/pamj.2018.29.52.13607.
[9] Gaffney RR, Moyer MT, Boehmer JP, et al. A big hole and a big heart: an unusual case of esophageal dysphagia[J]. Dis Esophagus, 2013, 26(3): 347-348. doi:10.1111/j.1442-2050.2012.01386.x.
[10] Gajanana D, Morris DL, Janzer SF, et al. Giant left atrium causing dysphagia[J]. Tex Heart Inst J, 2016, 43(5): 469-471. doi:10.14503/thij-15-5682.
[11] Heng JS, Elghamaz A. Atrial enlargement associated with non-valvular atrial fibrillation: an unusual cause of dysphagia and weight loss[J]. Case Rep, 2015, 2015(mar05 1): bcr2014209213. doi:10.1136/bcr-2014-209213.
[12] Hsu YC, Wu SS, Yen HH. An unusual cause of dysphagia in an elderly woman: dysphagia megalatriensis[J]. Am J Med Sci, 2019, 358(1): e1-e2. doi:10.1016/j.amjms.2019.02.018.
[13] Khurana V, Thakur SK. Cardiogenic dysphagia: dysphagia megalatriensis[J]. Am J Med Sci, 2018, 355(3): e9. doi:10.1016/j.amjms.2017.10.002.
[14] Meng ZR, Pereira M, Sharma A. An 89-year-old man with dysphagia due to an aortic aneurysm and enlarged left atrium[J]. Can Med Assoc J, 2020, 192(47): E1539. doi:10.1503/cmaj.200427.
[15] Semeraro L, Lénaud AV, McLin VA. Cardiovascular dysphagia[J]. J Pediatr Gastroenterol Nutr, 2012, 55(1): 1. doi:10.1097/mpg.0b013e318244a30b.
[16] Xie XJ, Xiong Q, Yu FX. Dysphagia caused by giant left atrium[J]. Eur Heart J, 2020, 41(16): 1603. doi:10.1093/eurheartj/ehaa024.
[17] 孙红艳. 1例多种因素引起吞咽困难患者的护理体会[J]. 中国美容医学, 2010, 19(z1): 185. doi:10.3969/j.issn.1008-6455.2010.z1.156.
[18] Behl PR, Holden MP. Mitral valve disease and dysphagia[J]. European heart journal, 1984, 5(11): 919-923. doi: doi:10.1111/j.1365-4362.1981.tb00460.x.
[19] Whitney B, Croxon R. Dysphagia caused by cardiac enlargement[J]. Clin Radiol, 1972, 23(2): 147-152. doi:10.1016/s0009-9260(72)80079-5.
[20] Morgan AA, Mourant AJ. Left vocal cord paralysis and dysphagia in mitral valve disease[J]. Heart, 1980, 43(4): 470-473. doi:10.1136/hrt.43.4.470.
[21] Cappell MS. Manometric findings in dysphagia secondary to left atrial dilatation[J]. Digest Dis Sci, 1991, 36(5): 693-698. doi:10.1007/bf01297040.
[22] 李飞, 姚俊, 刘磊峰. 复杂性食管异物的临床诊疗分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 85-89. doi: 10.6040/j.issn.1673-3770.0.2018.588. LI Fei, YAO Jun, LIU Leifeng. Clinical diagnosis and treatment of foreign bodies in a complex esophagus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 85-89. doi: 10.6040/j.issn.1673-3770.0.2018.588.
[1] 谷少尉,侯元友,魏东敏,李文明,陈东彦,徐晨阳,雷大鹏,潘新良. 声门上喉癌舌瓣修补术后吞咽功能恢复[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 127-131.
[2] 郝建海, 冀丽梅, 张俊瑶. 声嘶、吞咽困难为首发症状皮肌炎合并胃癌1例[J]. 山东大学耳鼻喉眼学报, 2015, 29(4): 90-91.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 周斌,李滨 . 鼻内窥镜下鼻窦鼻息肉手术75例疗效观察[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 24 -26 .
[2] 张玉光,韩旭光,张华,王旭,徐湘辉 . 改良穿透性角膜移植术治疗真菌性角膜炎[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 94 -95 .
[3] 隆梅辉,何明强,牟艳云,田利健 . 上颌窦炎性肌纤维母细胞瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2008, 22(4): 329 -330 .
[4] 邹 俊,卢 奕,褚仁远 . 体外培养人胚晶状体上皮细胞生长特性的研究[J]. 山东大学耳鼻喉眼学报, 2008, 22(5): 453 -456 .
[5] 夏文清,郑 敏,满晓飞,李建平 . 手法劈核治疗老年性白内障[J]. 山东大学耳鼻喉眼学报, 2008, 22(5): 467 -469 .
[6] 李学昌,王金磊,张玉莉,董文汇,韩在文 . 中药冲洗对鼻黏膜纤毛超微结构的影响[J]. 山东大学耳鼻喉眼学报, 2006, 20(6): 522 -524 .
[7] 康宏建,李晓红,王保安,周 涛 . 重型颅脑损伤患者行气管切开术的意义[J]. 山东大学耳鼻喉眼学报, 2007, 21(3): 234 -236 .
[8] 闫 蕊,朱淋洁 . 翼状胬肉显微手术切除后角膜干细胞移植[J]. 山东大学耳鼻喉眼学报, 2007, 21(3): 243 -244 .
[9] 黄 方,朱从月 . p21、p73及PTEN在头颈部多原发癌中的表达及意义[J]. 山东大学耳鼻喉眼学报, 2007, 21(5): 388 -392 .
[10] 徐豪杰,李学忠,陈成芳,王学海 . 鼻内镜下鼻腔泪囊吻合术17例[J]. 山东大学耳鼻喉眼学报, 2008, 22(2): 132 -134 .