Langes K, Bleifeld W
Medizinische Klinik, Abteilung Kardiologie, Universitätskrankenhaus Eppendorf, Hamburg.
Klin Wochenschr. 1991 Jan 4;69(1):37-45. doi: 10.1007/BF01649056.
We report on 4 patients in whom acute myocardial infarction was suspected due to acute onset of chest pain and elevation of the ST-segment. Furthermore in 2 patients the echocardiography revealed regional abnormal wall motion on admission, the others later. Coronary angiography showed normal coronary arteries in all cases. The left ventricular angiogram namely demonstrated regional abnormal wall motion. 2 patients developed a slight increase of the creatine phosphokinase including the CK-MB. Only one patient mentioned a grippal infectious disease 6 weeks before. During the hospital time all patients presented one of the inflammatory signs. A demonstration of the infectious agent was not possible in any of the cases. The endomyocardial biopsy was positive in two cases, and slightly positive in one case. Sometimes regional myocarditis might imitate an acute myocardial infarction. Both, the exact anamnesis and coronary angiography are necessary. The performance of an endomyocardial biopsy is desirable.
我们报告了4例因胸痛急性发作和ST段抬高而疑似急性心肌梗死的患者。此外，2例患者入院时经超声心动图显示局部室壁运动异常，其他患者随后出现。冠状动脉造影显示所有病例冠状动脉均正常。左心室造影显示局部室壁运动异常。2例患者肌酸磷酸激酶包括CK-MB略有升高。只有1例患者提到6周前患过流感样传染病。住院期间所有患者均出现炎症体征之一。所有病例均未能检测到感染病原体。心内膜心肌活检2例呈阳性，1例呈弱阳性。有时局部心肌炎可能会模仿急性心肌梗死。详细的病史和冠状动脉造影都是必要的。进行心内膜心肌活检是可取的。
