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以急性心肌梗死为表现的心室中部肥厚型梗阻性心肌病

Mid-ventricular hypertrophic obstructive cardiomyopathy presenting with acute myocardial infarction.

作者信息

Sato Yuichi, Matsumoto Naoya, Matsuo Shinro, Yoda Shunichi, Kunimoto Satoshi, Saito Satoshi

机构信息

Department of Cardiology, Nihon University School of Medicine, Tokyo, Japan.

出版信息

Tex Heart Inst J. 2007;34(4):475-8.

Abstract

Mid-ventricular hypertrophic obstructive cardiomyopathy is a rare type of cardiomyopathy that can be accompanied by apical aneurysm. We report the case of a patient who presented with ventricular fibrillation, ST-segment elevation on electrocardiography, and cardiac-enzyme elevation, in the presence of normal coronary arteries. Echocardiography and magnetic resonance imaging showed an hourglass appearance of the left ventricle with an aneurysm in the apex. Left-heart catheterization and continuous-wave Doppler echocardiography revealed a pressure gradient between the apical and basal chambers of the left ventricle. Impaired coronary artery circulation might play a role in the development of mid-ventricular obstruction in patients with mid-ventricular hypertrophic obstructive cardiomyopathy.

摘要

心室中部肥厚型梗阻性心肌病是一种罕见的心肌病类型,可伴有心尖部动脉瘤。我们报告了一例患者,其冠状动脉正常,但出现了室颤、心电图ST段抬高及心肌酶升高。超声心动图和磁共振成像显示左心室呈沙漏样外观,心尖部有动脉瘤。左心导管检查和连续波多普勒超声心动图显示左心室心尖部和基部腔室之间存在压力梯度。冠状动脉循环受损可能在心室中部肥厚型梗阻性心肌病患者的心室中部梗阻发展中起作用。

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