Fujimori M, Fukami K, Murooka M, Koeda T, Hiramori K, Tanaka H, Kimura H
Second Department of Internal Medicine, Iwate Medical University.
Kokyu To Junkan. 1993 Jul;41(7):683-7.
A 36-year-old man was hospitalized in December, 1990 because a small R wave was observed on his ECG in V1-3. The patient had suffered from a cold with fever for a month when he was a child. He had no symptoms or signs of myocardial infarction. The patient underwent selective right and left coronary angiography, which revealed specific coronary aneurysms in the left circumflex coronary artery and left anterior descending coronary artery. The aneurysm in the distal lesion of the left circumflex coronary artery was embolized by a thrombus and filled with many capillary arteries. The proximal lesion of the right coronary artery was slightly dilated. Good collateral flow from the right coronary artery to the left coronary artery was revealed by coronary angiography. Left ventriculograms were performed, and the anterior wall motion of the left ventricle was shown to the hypokinetic. A perfusion defect of the anterior wall of the left ventricle was revealed by Thallium-201 imaging with single photoemission computed tomography. Based on these findings, we diagnosed the patients' illness as old myocardial infarction caused by Kawasaki disease.(ABSTRACT TRUNCATED AT 250 WORDS)
一名36岁男性于1990年12月住院，原因是其心电图V1 - 3导联出现小R波。该患者儿童时期曾患感冒伴发热一个月。他没有心肌梗死的症状或体征。患者接受了选择性左右冠状动脉造影，结果显示左回旋支冠状动脉和左前降支冠状动脉存在特异性冠状动脉瘤。左回旋支冠状动脉远端病变处的动脉瘤被血栓栓塞，并充满许多毛细血管。右冠状动脉近端病变处稍有扩张。冠状动脉造影显示右冠状动脉向左冠状动脉有良好的侧支血流。进行了左心室造影，结果显示左心室前壁运动减弱。通过单光子发射计算机断层扫描的铊 - 201显像显示左心室前壁存在灌注缺损。基于这些发现，我们将该患者的病情诊断为川崎病所致的陈旧性心肌梗死。（摘要截选至250字）
