Mason J W, Strefling A
Am J Cardiol. 1979 Jul;44(1):171-6. doi: 10.1016/0002-9149(79)90267-4.
A 46 year old man who had undergone cardiac transplantation 1 year previously had progressive congestive heart failure without evidence of cardiac rejection. Cardiac catheterization and angiography revealed a reduced ejection fraction and cardiac output caused by diffuse left ventricular hypokinesia, but the epicardial coronary arteries were widely patent. The transit time of injected contrast material across the coronary arterial tree was greatly slowed. Within a few days cardiogenic shock and death occurred. The large epicardial coronary vessels were grossly patent at autopsy, although nonstenosing arteriosclerotic plaques were identifiable histologically. However, intramyocardial vessels showed severe arteriosclerotic narrowing, resulting in multiple, diffuse microinfarcts.
一名46岁男性，1年前接受了心脏移植，出现进行性充血性心力衰竭，无心脏排斥反应证据。心导管检查和血管造影显示，由于弥漫性左心室运动减弱，射血分数和心输出量降低，但心外膜冠状动脉广泛通畅。注入的造影剂在冠状动脉树中的通过时间大大减慢。数天内发生心源性休克并死亡。尸检时，大的心外膜冠状动脉大体通畅，尽管组织学上可识别出无狭窄的动脉粥样硬化斑块。然而，心肌内血管显示严重的动脉硬化狭窄，导致多处弥漫性微梗死。
