Loperfido F, Fiorilli R, Santarelli P, Di Gennaro M, Ansalone G, Bellocci F, Zecchi P
G Ital Cardiol. 1980;10(8):1077-84.
We present three cases of primary sclerodermic cardiopathy with an electrocardiographic picture of anterior myocardial infarction not preceded by chest pain. On one of the cases a coronary angiography was performed with negative results. The echocardiogram of case no 1 showed a pattern of congestive cardiomyopathy, while case no 2 showed a picture of an infiltrative cardiomyopathy. In case no 2 the electrocardiographic picture changed to that of a right bundle branch block with left posterior fascicular block and with the disappearance of the anterior infarction. The His bundle electrogram showed a prolongation of the HV interval, while hemodynamically no signs were shown of impaired mechanical heart function. The clinical and echocardiographic aspects of the sclerodermic cardiopathy are here discussed with particular reference to the possibility of the prevalent compromise of the conduction system that could explain the not uncommon incidence of sudden death.
我们报告三例原发性硬皮病性心肌病，其心电图表现为前壁心肌梗死，且无胸痛前驱症状。其中一例进行了冠状动脉造影，结果为阴性。病例1的超声心动图显示为充血性心肌病模式，而病例2显示为浸润性心肌病图像。病例2的心电图表现变为右束支传导阻滞伴左后分支阻滞，且前壁梗死消失。希氏束电图显示HV间期延长，而血流动力学方面未显示心脏机械功能受损的迹象。本文讨论了硬皮病性心肌病的临床和超声心动图方面，特别提及传导系统普遍受损的可能性，这可能解释了猝死的常见发生率。
