Mahé I, Lacroix D, Kouakam C, Kacet S
Service de Cardiologie A, Hôpital Cardiologique, CHRU Lille.
Presse Med. 1998 Dec 5;27(38):1947-50.
The first diagnostic hypothesis in a middle-aged patient presenting with inaugural ventricular tachycardia would be coronary artery disease. If the work-up lacks arguments for this etiology, other cardiac conditions may be involved (dilated cardiopathy, hypertrophic cardiopathy, valve disease arrhythmogenic dysplasia, long QT...).
A 52-year-old male patient was referred for inaugural ventricular tachycardia. The initial work-up including echocardiography, coronography and the electrophysiologic study provided no explanation. The ventricular tachycardia was later attributed to viral myocarditis.
Viral myocarditis should always be entertained in patients with unexplained ventricular tachycardia, particular if a viral context is present. In such cases, antibody-labeled scintigraphy is the choice exploration. This noninvasive technique provides determining diagnostic information and helps orient patient management.
对于初发室性心动过速的中年患者，首要的诊断假设是冠状动脉疾病。如果检查结果缺乏支持该病因的依据，则可能涉及其他心脏疾病（扩张型心肌病、肥厚型心肌病、瓣膜病、致心律失常性右室发育不良、长QT综合征……）。
一名52岁男性患者因初发室性心动过速前来就诊。包括超声心动图、冠状动脉造影和电生理研究在内的初步检查均未给出解释。该室性心动过速后来被归因于病毒性心肌炎。
对于不明原因的室性心动过速患者，尤其是存在病毒感染背景时，应始终考虑病毒性心肌炎。在这种情况下，抗体标记闪烁扫描是首选的检查方法。这种无创技术可提供决定性的诊断信息，并有助于指导患者的治疗管理。
