Aryanpur I, Raafat F, Ameli M, Tafazoli M, Massumi R A
Jpn Heart J. 1975 Sep;16(5):603-9. doi: 10.1536/ihj.16.603.
A 14-year-old boy, admitted with intractable chest pain, was found to have an enlarged heart and calcification in the apical region, with electrocardiographic features of massive inferolateral myocardial infarction. Left ventricular angiography revealed a large left ventricular aneurysm. He died following resection of the aneurysm and post mortem examination showed changes of a non-specific chronic myocarditis. A vasculitis involving small coronary arterioles was also found in the vicinity of the aneurysm, and the possibility of a rheumatic vasculitis was suggested by a transient episode of an erythema marginatum-like eruption. It is concluded that the association of infarction pattern on the electrocardiogram together with calcification of the heart in children is highly suggestive of a ventricular aneurysm secondary to a myocarditis or a vasculitis involving small, intramyocardial branches of the coronary arteries.
一名14岁男孩因顽固性胸痛入院，检查发现心脏扩大，心尖区钙化，心电图显示大面积下壁和侧壁心肌梗死特征。左心室血管造影显示巨大左心室室壁瘤。他在室壁瘤切除术后死亡，尸检显示为非特异性慢性心肌炎改变。在室壁瘤附近还发现了累及小冠状动脉小动脉的血管炎，游走性边缘性红斑样皮疹的短暂发作提示有风湿性血管炎的可能。结论是，儿童心电图上的梗死模式与心脏钙化相关，高度提示继发于心肌炎或累及冠状动脉心肌内小分支的血管炎的室壁瘤。
