Kusumoto Saburo, Kawano Hiroaki, Takeno Masayoshi, Yonekura Tsuyoshi, Koide Yuji, Abe Kuniko, Doi Yoshinori, Fukae Satoki, Komiya Norihiro, Maemura Koji
Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
Intern Med. 2012;51(18):2565-71. doi: 10.2169/internalmedicine.51.8285. Epub 2012 Sep 15.
A 67-year-old woman was referred to our hospital with a sudden syncopal attack. She suffered from cardiogenic shock due to left ventricular (LV) outflow stenosis with simultaneous complete atrioventricular (AV) block. An endomyocardial biopsy of the left ventricle demonstrated myocardial disarray and myocardial fibrous and edematous tissue with infiltration of mononuclear cells. Cardiac magnetic resonance imaging (cMRI) detected a damaged septal area that was likely associated with the conduction disturbance. The diagnosis was hypertrophic cardiomyopathy accompanied by acute myocarditis. Although the LV outflow stenosis was transient, the complete AV block was persistent, thus requiring permanent pacemaker implantation.
一名67岁女性因突发晕厥发作被转诊至我院。她因左心室流出道狭窄并伴有完全性房室传导阻滞而发生心源性休克。左心室心内膜活检显示心肌排列紊乱、心肌纤维和水肿组织伴有单核细胞浸润。心脏磁共振成像（cMRI）检测到一个可能与传导障碍相关的受损间隔区域。诊断为肥厚型心肌病伴急性心肌炎。尽管左心室流出道狭窄是短暂的，但完全性房室传导阻滞持续存在，因此需要植入永久性起搏器。
