来源：医学英语读读吧作者：NEJM/MedlinePlus
Parasternaladj.胸骨旁的
Transthoracicadj.经胸的
Transmitraladj.经二尖瓣的
A47-year-oldmanpresentedtotheemergencydepartmentwitha6-monthhistoryofworseningexertionaldyspnea.HehadrecentlyemigratedfromHondurasandhadahistoryofcardiacsurgeryasachild,buttheinitialdiagnosisandspecificprocedurethathadbeenperformedwerenotknown.Thephysicalexaminationrevealedarightparasternalheave,aloudS1,amidpeakingsystolicejectionmurmur(grade2/6)attheuppersternalborder,andalow-pitcheddiastolicrumbleattheapex.Anelectrocardiogramshowedatrialflutterwithvariableatrioventricularconduction.Transthoracicechocardiographyrevealedmoderateaorticstenosisandveryseveremitralstenosis(seevideoatNEJM.org).Theleftatriumwasenlarged,withanindexedatrialvolumeofmlpersquaremeter.ColorflowDopplerimagesandacontinuouswaveDopplerflowpatternshowedthestenoticmitralvalveduringdiastole.Theslowdeclineintransmitralflowvelocityreflectstheveryslowdecreaseinleftatrialpressureandslowincreaseinleftventriculardiastolicpressurethatoccurinmitralstenosis.Thepatientunderwentreplacementofthemitralandaorticvalveswithmechanicalprostheses.Ata6-monthfollow-upvisit,hehadonlyslightlimitationsonphysicalactivity.1
一名47岁男子因劳累性呼吸困难加重6个月急诊就诊。最近他从洪都拉斯移民来美国，有儿时心脏手术史，但最初的诊断和具体实施的手术不详。体格检查显示右侧胸骨旁可见隆起、第一心音响亮、胸骨边缘上部收缩中早期喷射性杂音（2/6级）以及心尖部低调的舒张期隆隆样杂音。心电图显示心房扑动伴有房室传导比例不定。经胸超声心动图显示中度主动脉瓣狭窄和严重的二尖瓣狭窄（在NEJM.org上观看视频）。左心房扩大，心房容积指数为每平方米毫升。彩色血流多普勒图像和连续波多普勒血流模式显示舒张期的狭窄二尖瓣。经二尖瓣血流速度缓慢下降，反映了发生在二尖瓣狭窄的左心房压力缓慢降低和左心室舒张压缓慢增加。患者进行二尖瓣和主动脉瓣的机械瓣置换术。6个月随访中，患者只有轻微的身体活动受限。
1.常用医学词组
exertionaldyspnea
劳力性呼吸困难
atrialflutter心房扑动
AtrialFlutter心房扑动
atrioventricularconduction
房室传导
aorticstenosis主动脉瓣狭窄
主动脉瓣狭窄AorticValveStenosis
mitralstenosis二尖瓣狭窄
leftatrium左心房
colorflowDopplerimage
彩色血流多普勒图像
acontinuouswaveDopplerflowpattern
连续波多普勒血流模式
leftventriculardiastolicpressure
左室舒张压
2.常用英语表述方式
毫升/平方米表述为
milliliterpersquaremeter
Mitralstenosismeansthatthevalvecannotopenenough.Asaresult,lessbloodflowstothebody.Theupperheartchamberswellsaspressurebuildsup.Bloodandfluidmaythencollectinthelungtissue(pulmonaryedema),makingithardtobreathe.Inadults,mitralstenosisoccursmostofteninpeoplewhohavehadrheumaticfever.Thisisadiseasethatcandevelopafteranillnesswithstrepthroatthatwasnotproperlytreated.
Thevalveproblemsdevelop5to10yearsormoreafterhavingrheumaticfever.Symptomsmaynotshowupforevenlonger.Rheumaticfeverisbe
