Daskalov T R, Prodanov A, Raĭchev N
Vutr Boles. 1986;25(4):103-7.
Two patients are described, aged 60, with acute symptomless myocardial infarctions, diagnosed while still alive by electrocardiography, on the background of predominating neurological symptomatics, admitted as a manifestation of ischemic cerebral strokes, and in one of the patients--as embolization of peripheral artery, confirmed at operation. Multiple embolism and infarctions, with different duration, of brain and some other internal organs were established at necropsy, that originated from abacterial thromboendocarditis of aortic valve that developed in the absence of other diseases or data for the existence of disseminated intravasal coagulation. In the first case--extensive posterior-septal myocardial infarction was established and in the second--two not extensive infarctions, localized high anterior-septally and in the free anterior left ventricular wall. Though embolic deposits were not established in the large coronary arteries, the combination of acute myocardial infarctions and embolizing thromboendocarditis, in the absence of stenosing coronary atheromatosis, makes the embologenic origin of infractions most probable.
本文描述了两名60岁的患者,他们患有急性无症状心肌梗死,在以神经症状为主导的背景下,通过心电图在生前被诊断出来,因缺血性脑卒中来就诊,其中一名患者还因外周动脉栓塞就诊,手术时得到证实。尸检发现大脑和其他一些内脏器官存在不同病程的多发性栓塞和梗死,其起因是主动脉瓣的无菌性血栓性心内膜炎,该疾病在没有其他疾病或弥散性血管内凝血证据的情况下发生。第一例患者确诊为广泛的后间隔心肌梗死,第二例患者有两处不广泛的梗死,分别位于高前间隔和左心室前游离壁。虽然在大冠状动脉中未发现栓塞沉积物,但在没有冠状动脉粥样硬化狭窄的情况下,急性心肌梗死与栓塞性血栓性心内膜炎并存,使得梗死的栓子源性极有可能。