Monmeneu J V, Bodí V, Sanchís J, Chorro F J, Llopis R, Insa L, López Merino V
Servicio de Cardiología, Hospital Clínico Universitario de Valencia.
Rev Esp Cardiol. 1995 Nov;48(11):768-70.
A male patient presented with symptoms of angor under effort. Echocardiography and angiocardiography revealed apical hypertrophic myocardiopathy, associated with multiple fistulas connecting the anterior descending coronary artery and right coronary artery with the cavity of the left ventricle, as demonstrated by coronariography. We comment on the hypothesis that support a causal relationship between the two anomalies, microfistulas being the possible cause of the reactive hypertrophy through the induction of a coronary steal phenomenon with local ischemia; alternatively, the myocardiopathy itself might be the cause of microfistulas formation by inducing an anomaly in the Thebesius venous system. A pathogenic relationship is suggested between the syndrome of angor and these two rare pathological entities.
一名男性患者出现劳力性呼吸困难症状。超声心动图和心血管造影显示为心尖肥厚型心肌病，冠状动脉造影显示前降支冠状动脉和右冠状动脉与左心室腔之间存在多处瘘管。我们对支持这两种异常之间存在因果关系的假说进行了评论，微瘘可能是通过诱发局部缺血的冠状动脉窃血现象而导致反应性肥厚的原因；或者，心肌病本身可能通过诱发心最小静脉系统异常而导致微瘘形成。提示劳力性呼吸困难综合征与这两种罕见的病理实体之间存在致病关系。
