Okamoto M, Hashimoto M, Sueda T, Munemori M, Yamada T
Department of Cardiology, Hiroshima Prefectural Hospital.
Intern Med. 1994 May;33(5):296-9. doi: 10.2169/internalmedicine.33.296.
A 38-year-old female had felt exertional dyspnea for six months. Physical examination and laboratory data including angiotensin-converting enzyme, failed to diagnose sarcoidosis. Her chest X-ray showed cardiomegaly but no hilar lymph node enlargement. Holter ECG showed nonsustained and sustained ventricular tachycardias, monomorphic or polymorphic tachycardia. Echocardiography and contrast left ventriculography showed left ventricular dilatation and generalized hypo- and akinesis. Endomyocardial biopsy revealed myocardial sarcoidosis. Administration of corticosteroids, metoprolol of 20 mg/day and cibenzoline of 300 mg/day was markedly effective for the treatment of ventricular tachycardia. This patient is alive for one year after treatment and the combination therapy seems to contribute to good prognosis.
一名38岁女性感到劳力性呼吸困难已有6个月。体格检查及包括血管紧张素转换酶在内的实验室检查数据均未能诊断出结节病。她的胸部X线片显示心脏扩大，但肺门淋巴结无肿大。动态心电图显示非持续性和持续性室性心动过速，单形性或多形性心动过速。超声心动图和左心室造影显示左心室扩张及普遍运动减弱和运动不能。心内膜心肌活检显示心肌结节病。给予皮质类固醇、每日20毫克美托洛尔和每日300毫克西苯唑啉对室性心动过速的治疗效果显著。该患者治疗后存活了一年，联合治疗似乎有助于良好的预后。
