左心房增大导致吞咽困难疑似食管异物1例并文献复习

doi:10.6040/j.issn.1673-3770.1.2021.246

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

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. 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 Qing^1,2, WANG Xiaoyong³, JIA Chuanliang², MOU Yakui², SONG Xicheng²

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/Abstract

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

宋晴,王晓勇,贾传亮,牟亚魁,宋西成. 左心房增大导致吞咽困难疑似食管异物1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 64-67.

SONG Qing, WANG Xiaoyong, JIA Chuanliang, MOU Yakui, SONG Xicheng. Dysphagia due to left atrial enlargement: a case report and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 64-67.

参考文献

[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.

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左心房增大导致吞咽困难疑似食管异物1例并文献复习

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

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