Int J Cardiol. 2009 Jul 10;135(3):e73-5. doi: 10.1016/j.ijcard.2008.04.038. Epub 2008 Jul 17.
Focal tissue abnormalities consistent with regional ischemia have been reported in patients with hypertrophic cardiomyopathy (HCM). Coronary microvascular dysfunction has been also reported to be present in patients with HCM despite normal epicardial coronary arteries. Moreover, it has been demonstrated that in the case of HCM and idiopathic left ventricular hypertrophy, hypoplastic coronary arteries as diminutive vessels are present and that obstructive hypertrophic cardiomyopathy is associated with enhanced thrombin generation and platelet activation. Previously, it has been described an acute myocardial infarction in a young athlete with non-obstructive hypertrophic cardiomyopathy and normal coronary arteries. We present a case of an acute myocardial infarction with diminutive right coronary artery and obstructive hypertrophic cardiomyopathy without significant coronary stenoses. To our knowledge, this is the first report of an acute myocardial infarction with diminutive right coronary artery and obstructive hypertrophic cardiomyopathy without significant coronary stenoses.
已有报道称肥厚型心肌病（HCM）患者存在局灶性组织异常，符合局部缺血表现。尽管心外膜冠状动脉正常，但也有报道称 HCM 患者存在冠状动脉微血管功能障碍。此外，已经证明在 HCM 和特发性左心室肥厚的情况下，小冠状动脉作为细小血管存在，而梗阻性肥厚型心肌病与增强的凝血酶生成和血小板激活有关。此前曾有描述过一例非梗阻性肥厚型心肌病和正常冠状动脉的年轻运动员发生急性心肌梗死。我们报告了一例急性心肌梗死合并右冠状动脉细小和梗阻性肥厚型心肌病而无明显冠状动脉狭窄的病例。据我们所知，这是首例报道的急性心肌梗死合并右冠状动脉细小和梗阻性肥厚型心肌病而无明显冠状动脉狭窄的病例。
