一例由急性B19微小病毒心肌炎引发的罕见急性“感染性”心肌梗死病例。
A rare case of acute 'infective' myocardial infarction triggered by acute parvovirus B19 myocarditis.
作者信息
Gutersohn Achim, Zimmermann Ulrich, Bartel Thomas, Erbel Raimund
机构信息
Department of Cardiology, University Duisburg-Essen, Germany.
出版信息
Nat Clin Pract Cardiovasc Med. 2005 Mar;2(3):167-71. doi: 10.1038/ncpcardio0126.
BACKGROUND
A 25-year-old obese male (BMI 31.9 kg/m(2)) presented with atypical chest pain of sudden onset that was indistinguishable from acute myocardial infarction. He had tachycardia (104 beats/min) and dyspnea at a low level of exercise. He had no previous cardiac history, but his cardiovascular risk profile included a familial predisposition, smoking and hypertension.
INVESTIGATIONS
Electrocardiogram, laboratory testing, chest radiography, echocardiography, coronary angiography, intravascular ultrasonography and endomyocardial biopsy.
DIAGNOSIS
Acute myocardial infarction and parvovirus-B19-positive myocarditis.
MANAGEMENT
Percutaneous transluminal coronary angioplasty with intracoronary abciximab, heparin and nitroglycerin infusion.
背景
一名25岁肥胖男性（体重指数31.9kg/m²），突发非典型胸痛，与急性心肌梗死难以区分。他在低强度运动时出现心动过速（104次/分钟）和呼吸困难。他既往无心脏病史，但其心血管风险因素包括家族易感性、吸烟和高血压。
检查
心电图、实验室检查、胸部X线、超声心动图、冠状动脉造影、血管内超声和心内膜活检。
诊断
急性心肌梗死和细小病毒B19阳性心肌炎。
治疗
经皮腔内冠状动脉成形术，术中给予冠状动脉内阿昔单抗、肝素和硝酸甘油输注。
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