经心内膜心肌活检诊断的心脏淀粉样变性

Kim M A, Kim C H, Oh B H, Park Y B, Choi Y S, Seo J D, Lee Y W

Korean J Intern Med. 1988 Jul;3(2):148-53. doi: 10.3904/kjim.1988.3.2.148.

A 56-year-old male patient who had a history of syncopal attack was diagnosed as having cardiac amyloidosis. His ECG finding showed a pattern of inferior and anteroseptal wall infarction with Wenckebach AV block. Echocardiographic examination revealed that the LV posterior wall and interventricular septum were markedly thickened with granular sparkling. We demonstrated the amyloid deposit in the myocardium by endomyocardial biopsy. Pathology showed a green white birefringence by polarizing illumination and amyloid fibril in electron microscopic study.

一名有晕厥发作史的56岁男性患者被诊断为心脏淀粉样变性。他的心电图表现为下壁和前间隔壁梗死伴文氏房室传导阻滞模式。超声心动图检查显示左心室后壁和室间隔明显增厚，伴有颗粒状闪光点。我们通过心内膜活检证实了心肌中的淀粉样蛋白沉积。病理学显示在偏振光照射下呈绿白色双折射，电子显微镜研究显示有淀粉样纤维。