Lê Quang C, Kouzez M, Welsch C, Ravan R, Ferrier N, Cassan P, Marcaggi X, Amat G
Service de cardiologie, centre hospitalier de Vichy, boulevard Denière, 03200 Vichy, France.
Ann Cardiol Angeiol (Paris). 2008 Nov;57(5):307-10. doi: 10.1016/j.ancard.2008.08.009. Epub 2008 Sep 24.
A 50-year-old male patient treated with mesalazine for Crohn's disease was admitted in our unit for a chest pain, associated with nonspecific ST depression or ECG and troponin elevation. Coronarography showed minimal changes while SPECT imagery suggested a posterobasal subendocardial infarction, so that the diagnosis was unclear between ischemic disease and mesalazine-induced myocarditis. Eventually, MRI demonstrated clearly a subendocardial posterior infarction eliciting the diagnosis of mesalazine-induced myocarditis. This case report illustrates, in our opinion, that MRI is of invaluable interest in evaluating the characteristics of myocardium, and must be the cornerstone in the diagnosis of myocardial diseases.
一名50岁男性克罗恩病患者,因使用美沙拉嗪治疗而入住我院,主诉胸痛,伴有非特异性ST段压低或心电图及肌钙蛋白升高。冠状动脉造影显示变化轻微,而单光子发射计算机断层扫描(SPECT)图像提示后基底心内膜下梗死,因此缺血性疾病和美沙拉嗪诱发的心肌炎之间的诊断不明确。最终,心脏磁共振成像(MRI)清晰显示心内膜下后壁梗死,从而确诊为美沙拉嗪诱发的心肌炎。我们认为,该病例报告表明,MRI在评估心肌特征方面具有极高价值,且必定是心肌疾病诊断的基石。