Przybojewski J Z, Hunter J, Laubscher J
S Afr Med J. 1986 Apr 26;69(9):576-80.
A 43-year-old coloured man had no risk factors for atheromatous coronary artery disease but suffered two acute myocardial infarctions (MIs) in rapid succession. Serological reactions for previous syphilitic (luetic) infection were positive. Hypertrophic cardiomyopathy (HCM) without obstruction was verified, although right ventricular endomyocardial biopsy specimens did not demonstrate histological features of this disease. Extensive MI was verified on left ventricular cine angiography. Selective coronary arteriography showed that the coronary arterial tree was diffusely aneurysmal in the absence of any obstruction. We postulate that syphilitic coronary arteritis, in the absence of the more pathognomonic coronary ostial stenotic lesions, was present and may have predisposed to coronary thrombus formation and repeated acute MI. Recurrent coronary vasospasm, associated with the HCM, cannot be excluded with certainty.
一名43岁的有色人种男性没有动脉粥样硬化性冠状动脉疾病的危险因素，但却接连两次发生急性心肌梗死（MI）。既往梅毒感染的血清学反应呈阳性。尽管右心室心内膜活检标本未显示肥厚型心肌病（HCM）的组织学特征，但仍证实存在无梗阻性肥厚型心肌病。左心室电影血管造影证实存在广泛的心肌梗死。选择性冠状动脉造影显示冠状动脉树弥漫性动脉瘤形成，无任何梗阻。我们推测，在没有更具特征性的冠状动脉开口狭窄病变的情况下，存在梅毒性冠状动脉炎，这可能易导致冠状动脉血栓形成和反复急性心肌梗死。与肥厚型心肌病相关的复发性冠状动脉痉挛也不能完全排除。
