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Vojnosanitetski pregled
2018, vol. 75, br. 2, str. 228-233
jezik rada: engleski
vrsta rada: prikaz slučaja
doi:10.2298/VSP160124354R

Creative Commons License 4.0
Nekompaktna leva komora kao uzrok srčane slabosti
aUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Clinic for Emergency and Internal Medicine, Belgrade
bUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Clinic for Cardiology, Belgrade
cUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Institute for Radiology, Belgrade
dMilitary Medical Center 'Slavija', Belgrade
eInternal Medicine Practice 'Nada-a', Belgrade
fSpecialistic Nuclear Medicine Practice 'Dr Baškot'

Sažetak

Uvod. Nekompaktna leva komora (NKLK) je urođena bolest koju karakteriše izrazita trabekularizacija miokarda leve komore. Vrlo često se promene na srcu potpuno previde ili se zamene za hipertrofiju miokarda ili koronarnu bolest. Prikaz bolesnika. Bolesnica srednjih godina, sa porodičnim opterećenjem za koronarnu bolest, primljena je zbog bolova u grudima, promena u elektrokardiogramu (EKG-u) u zoni inferolateralnog zida i porasta kardiospecifičnih enzima. U prvom trenutku posumnjalo se na akutni koronarni sindrom. Međutim, na ultrazvučnom pregledu srca, u vrhu leve komore, posebno duž lateralnog i donjeg zida, viđena je hipertrabekularizacija sa brojnim resicama koje su prominirale u šupljinu leve komore. Poprečni presek srca iznad papilarnih mišića ukazao je na postojanje dva sloja miokarda: uz epikard je bio prisutan kompaktan i homogen sloj, a ispod endokarda rastresist sloj sa trabekulama i sinusoidima. Odnos debljine ova dva sloja iznosio je 2,2:1. Iste promene potvrđene su na multislajsnoj kompjuterizovanoj tomografiji (MSCT) srca. Zaključak. Nekompaktna leva komora je retka, najčešće nasledna kardiomiopatija, na koju treba misliti kod bolesnika sa hipertrofijom miokarda. Vrlo često se zamenjuje za koronarnu bolest zbog promena u EKG-u i porasta kardiospecifičnih enzima koji su posledica hipertrofije miokarda i srčane slabosti.

Ključne reči

srce; disfunkcije leve komore; srce; insuficijencija; miokard; komorni; izolovana nonkompakcija; aa. coronariae; spazam; ehokardiografija; tomografija; dijagnoza; diferencijalna

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