每日一题_2023.06.06

A 9-year-old girl is brought to the emergency department with an arrhythmia that started while she was sitting in class. Since birth she has had a disorder that predisposes her to arrhythmias, but because her parents were not present, the hospital staff was unable to determine her medical history. The staff attempts to treat the patient with an atrioventricular nodal block antiarrhythmic, which does not cure the problem and instead makes it worse. What congenital pathophysiology could this girl have had?

一名9岁女孩因在上课时出现心律失常被送到急诊科。自出生以来，她就患有一种使她容易出现心律失常的疾病，但由于她的父母不在场，医院工作人员无法确定她的病史。医护人员试图用房室结阻滞抗心律失常药治疗患者，但这并不能治愈问题，反而使问题恶化。这个女孩可能有什么先天的病理生理?

(A) Atrioventricular accessory tract 房室旁道

(B) Atrioventricular nodal re-entry 房室结折返

(C) Tetralogy of Fallot 法洛四联症

(D) Ventricular hypertrophy 心室肥大

(E) Ventricular tachycardia 室性心动过速

答案解析：

患者可能有一个异常的心房折返道，它绕过房室结，直接从心房进入心室。这就是为什么房室结阻滞药物不起作用，而是为异常的通道提供了一条无阻力的通路。由此引起的综合征是沃尔夫-帕金森-怀特综合征。Wolff-Parkinson-White 综合征 (WPW) 是一种以心脏电脉冲异常传导为特征的疾病，由存在一个或多个辅助房室束引起，可引起散发性心动过速发作。

正确答案：A