Bex J P, Laborde F, Baillot F, Martelli H, Hazan E
Arch Mal Coeur Vaiss. 1980 May;73(5):535-7.
The anomalous origin of the left coronary artery is almost the only cause of neonatal myocardial infarction. Other rare causes have been proposed when haemodynamic studies have shown a normal coronary tree. An 18 months old child, born prematurely at the 6th month of pregnancy (in a moribund condition), presented with a postero lateral myocardial infarction and congestive cardiac failure resistant to drug therapy. Angiography showed anormal coronary tree, massive mitral incompetence and a left ventricular aneurysm. The mechanical complications of the infarct were treated surgically with a good result, 2 years postoperatively. The possible aetiologies of the infarction are discussed: embolism, thrombosis, blood disorder, infection, and cardiorespiratory failure at birth in a premature baby. This case shows that the complications of myocardial infarction in childhood may be treated surgically without coronary revascularisation when the coronary arteries are normal. The exact cause of the infarction remain uncertain.
左冠状动脉异常起源几乎是新生儿心肌梗死的唯一原因。当血流动力学研究显示冠状动脉正常时，也提出了其他罕见原因。一名18个月大的儿童，在妊娠6个月时早产（处于濒死状态），出现后外侧心肌梗死和药物治疗无效的充血性心力衰竭。血管造影显示冠状动脉正常、大量二尖瓣反流和左心室动脉瘤。梗死的机械性并发症在术后2年接受了手术治疗，效果良好。讨论了梗死可能的病因：栓塞、血栓形成、血液疾病、感染以及早产婴儿出生时的心肺衰竭。该病例表明，当冠状动脉正常时，儿童心肌梗死的并发症可在不进行冠状动脉血运重建的情况下接受手术治疗。梗死的确切原因仍不确定。
