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心内膜心肌活检发现细小病毒B19基因组的应激性心肌病(心尖部气球样变)

Tako-Tsubo cardiomyopathy (apical ballooning) with parvovirus B19 genome in endomyocardial biopsy.

作者信息

Bahlmann Edda, Schneider Carsten, Krause Korff, Pankuweit Sabine, Härle Tobias, Kuck Karl-Heinz

出版信息

Int J Cardiol. 2007 Mar 2;116(1):e18-21. doi: 10.1016/j.ijcard.2006.08.063. Epub 2006 Nov 13.

Abstract

The phenomenon of transient apical ballooning is a rare underlying cause of severe left ventricular dysfunction and has been described as Tako-Tsubo-like cardiomyopathy. Acute myocarditis has been reported to masquerade as acute myocardial infarction or vice versa and is considered as differential diagnosis in this phenomenon. We present here a case of an adult female who was admitted to our cardiology department with chest pain, electrocardiographic and echocardiographic features, suggestive of an acute anterior myocardial infarction, preceded by physical and emotional stress. Coronary angiography demonstrated coronary arteries without relevant atherosclerotic lesions; left ventriculography showed a severe anteroapical dysfunction. Right ventricular endomyocardial biopsy showed normal cardiac tissue, but was positive for Parvovirus B19. Follow-up (2 months later) showed complete regression of regional wall motion abnormalities in transthoracic echocardiography.

摘要

短暂性心尖气球样变现象是严重左心室功能障碍的一种罕见潜在病因,被描述为应激性心肌病样心肌病。据报道,急性心肌炎可伪装成急性心肌梗死,反之亦然,在这种现象中被视为鉴别诊断。我们在此报告一例成年女性病例,该患者因胸痛、心电图和超声心动图特征提示急性前壁心肌梗死而入住我们的心脏病科,发病前有身体和情绪应激。冠状动脉造影显示冠状动脉无相关动脉粥样硬化病变;左心室造影显示严重的心尖前功能障碍。右心室心内膜活检显示心脏组织正常,但细小病毒B19检测呈阳性。随访(2个月后)经胸超声心动图显示局部室壁运动异常完全消退。

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