小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
其他诊断因素
- 呼吸困难
- 运动耐量下降
- 舒张期杂音
- 端坐呼吸
- 阵发性夜间呼吸困难
- 心悸
- 疲劳
- 发汗
- 心尖搏动最强点移位
- 收缩期杂音
- 右心衰竭体征
危险因素
- 肺动脉高压
- 法洛四联症、肺动脉瓣狭窄及闭锁的外科矫治
- 心内膜炎
- 左心系统疾病
- 曾接受 Ross 手术（人工肺瓣膜/同种肺动脉瓣置换术）
- 胶原血管病
- 恶性肿瘤累及主肺动脉
诊断性检查
首要检查
- 心电图 (ECG)
- 经胸多普勒超声心动图
- 胸部 X 线检查 (CXR)
需考虑的检查
- 经食管多普勒超声心动图
- 胸部 MRI
- 胸部 CT 扫描
- 心脏磁共振成像
治疗流程
急性肺动脉瓣反流
慢性肺动脉瓣反流
撰稿人
作者
Sachin S. Goel, MD
Interventional Cardiology
Prairie Heart Institute at St John's Hospital
Springfield
IL
利益声明
SSG declares that he has no competing interests.
Chetan P. Huded, MD, MSc
Interventional Cardiology Fellow
Department of Cardiovascular Medicine
Cleveland Clinic
Cleveland
OH
利益声明
CPH declares that he has no competing interests.
Samir Kapadia, MD
Director of Cardiac Cath Lab
Professor of Medicine
Department of Cardiovascular Medicine
Cleveland Clinic
Cleveland
OH
利益声明
SK declares that he has no competing interests.
鸣谢
We would like to acknowledge our cardiology expert panel member, Dr Thoralf M. Sundt, for his contribution to this topic.
Dr Sachin S. Goel, Dr Chetan P. Huded, and Dr Samir Kapadia would like to gratefully acknowledge Dr Mehdi H. Shishehbor, the previous contributor to this topic.
利益声明
TS declares that he has no competing interests. MHS declares that he has no competing interests.
同行评议者
Satish Adwani, MD
Consultant in Paediatric Cardiology and Adults with Congenital Heart Disease
John Radcliffe Hospital
Oxford
UK
利益声明
SA declares that he has no competing interests.
Sarabjeet Singh, MD
Cardiology Fellow
Adult Cardiovascular Fellowship
Department of Cardiology
Chicago Medical School (CMS) and affiliated hospitals
Chicago
IL
利益声明
SS declares that he has no competing interests.
Debabrata Mukherjee, MD
Gill Foundation Professor of Interventional Cardiology
Director of Cardiac Catheterization Laboratories
Gill Heart Institute
Division of Cardiovascular Medicine
University of Kentucky
Lexington
KY
利益声明
DM declares that he has no competing interests.
Syed Wamique Yusuf, MD, MRCPI, FACC
Associate Professor
University of Texas MD Anderson Cancer Center
Department of Cardiology
Houston
TX
利益声明
SWY declares that he has no competing interests.
鉴别诊断
- 二尖瓣狭窄
- 主动脉瓣反流
- 心房黏液瘤
更多 鉴别诊断指南
- ESC 2020 年成人先天性心脏病管理指南
- 2020 年 ACC/AHA 心脏瓣膜病患者管理指南
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