Kelly T A, Watson D D, DiMarco J P, Gibson R S
Chest. 1987 Aug;92(2):371-4. doi: 10.1378/chest.92.2.371.
The case reported herein illustrates an unusual form of nonobstructive hypertrophic cardiomyopathy which was associated with Wolff-Parkinson-White syndrome, myocardial ischemia and necrosis despite normal coronary arteries. The patient is unique since the hypertrophied myocardial segment was localized exclusively to the posterolateral free wall. Quantitative thallium-201 scintigraphy demonstrated reversible ischemia that corresponded precisely with this region of posterolateral hypertrophy. While the exact mechanism for ischemia in patients with hypertrophic cardiomyopathy and normal coronary arteries remains controversial, a functional rather than anatomic disturbance of blood flow seems likely.
本文报道的病例显示了一种不寻常的非梗阻性肥厚型心肌病，该病例与 Wolff-Parkinson-White 综合征、心肌缺血及坏死相关，尽管冠状动脉正常。该患者很独特，因为肥厚的心肌节段仅局限于后外侧游离壁。定量铊-201 心肌显像显示可逆性缺血，这与后外侧肥厚区域精确对应。虽然肥厚型心肌病且冠状动脉正常的患者发生缺血的确切机制仍存在争议，但血流的功能性而非解剖性紊乱似乎是可能的原因。
