Takeno Yasuko, Eno Shin, Hondo Tatsuya, Matsuda Keiji, Zushi Naomi
Department of Cardiology, Chugoku Rosai General Hospital, Hirotagaya 1-5-1, Kure, Hiroshima 737-0193.
J Cardiol. 2004 Jun;43(6):281-7.
A 59-year-old male was admitted to the emergency department because of sustained chest oppression. Electrocardiography revealed J type ST depression and peaked T wave in leads II, III, aVF, and V4-V6. No stenosis was found in the coronary arteries by urgent coronary angiography. Left ventricular abnormal wall movement with akinesis in the base and hyperkinesis in the apical area was observed and improved on the 12th day. Myocardial scintigraphy with iodine-123-metaiodobenzylguanidine showed completely defective images and decreased accumulation in the base with combined thallium-201 and iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid. Myocardial biopsy on the 12th day disclosed contraction band necrosis. The diagnosis was catecholamine-induced cardiomyopathy caused by pheochromocytoma.
一名59岁男性因持续性胸部压迫感入住急诊科。心电图显示II、III、aVF及V4 - V6导联出现J型ST段压低和T波高尖。紧急冠状动脉造影未发现冠状动脉狭窄。观察到左心室壁运动异常,基底部运动减弱,心尖部运动增强,并在第12天有所改善。用碘 - 123 - 间碘苄胍进行心肌闪烁显像显示图像完全缺损,在联合使用铊 - 201和碘 - 123 - β - 甲基 - p - 碘苯基 - 十五烷酸时,基底部摄取减少。第12天的心肌活检显示有收缩带坏死。诊断为嗜铬细胞瘤引起的儿茶酚胺诱导性心肌病。