Ro Thomas K, Lang Roberto M, Ward R Parker
Noninvasive Imaging Laboratories Section of Cardiology, University of Chicago Medical Center, IL 60637, USA.
J Am Soc Echocardiogr. 2004 Apr;17(4):387-90. doi: 10.1016/j.echo.2003.11.014.
Acute pancreatitis has frequently been reported to be associated with transient electrocardiography changes mimicking myocardial infarction despite normal epicardial coronary arteries. Although these reports generally have not included simultaneous assessment of myocardial function, 1 previous report has documented suggestive electrocardiography changes associated with a transient regional wall-motion abnormality but normal epicardial coronary arteries. Although the origin of these findings is poorly understood, suggested mechanisms have included electrolyte abnormalities, a vagally mediated reflex, coronary vasospasm, and myonecrosis as a result of the release of pancreatic proteolytic enzymes. We report a case of acute pancreatitis with electrocardiography changes and a regional wall-motion abnormality despite normal epicardial coronary arteries. Myocardial contrast echocardiography performed in this patient to evaluate the coronary microcirculation allows further insight into the mechanism of these findings.
急性胰腺炎常被报道与类似心肌梗死的短暂心电图改变相关，尽管心外膜冠状动脉正常。虽然这些报道一般未包括对心肌功能的同步评估，但之前有一份报告记录了与短暂性局部室壁运动异常相关但心外膜冠状动脉正常的提示性心电图改变。尽管对这些发现的起源了解甚少，但推测的机制包括电解质异常、迷走神经介导的反射、冠状动脉痉挛以及胰腺蛋白水解酶释放导致的心肌坏死。我们报告一例急性胰腺炎患者，尽管心外膜冠状动脉正常，但有心电图改变和局部室壁运动异常。对该患者进行心肌对比超声心动图检查以评估冠状动脉微循环，有助于进一步深入了解这些发现的机制。
