Dean J W, Kuo J, Wood A J
Cardiac Department, Royal London Hospital, UK.
Int J Cardiol. 1993 Sep;41(2):165-7. doi: 10.1016/0167-5273(93)90157-c.
A 44-year-old man with aortic valve disease presented with myocardial ischaemia and ultimately infarction in the presence of suspected endocarditis. Thoracic computerised tomographic scan and coronary arteriography suggested the ischaemia was caused by external compression of the left coronary artery due to an aortic root abscess, later confirmed at surgery. Myocardial ischaemia is an infrequent accompaniment of infective endocarditis and is most commonly due to coexisting coronary disease. More rarely, emboli from vegetations may give rise to infarction. Although aortic root abscess is a well recognised complication of aortic valve endocarditis, coronary artery compression is an unusual mode of presentation and we believe this to be the first reported case of myocardial infarction resulting from external compression in this setting.
一名患有主动脉瓣疾病的44岁男性，在疑似心内膜炎的情况下出现心肌缺血，最终发展为心肌梗死。胸部计算机断层扫描和冠状动脉造影显示，缺血是由主动脉根部脓肿对左冠状动脉的外部压迫所致，手术后来得以证实。心肌缺血是感染性心内膜炎较少见的伴随症状，最常见的原因是并存的冠状动脉疾病。更罕见的是，赘生物脱落的栓子可能导致梗死。虽然主动脉根部脓肿是主动脉瓣心内膜炎公认的并发症，但冠状动脉受压是一种不寻常的表现形式，我们认为这是首例关于这种情况下外部压迫导致心肌梗死的报道病例。
