小兒原發性心肌症

Primary Myocardial Diseases in Infancy and Children

呂鴻基(Hung-Chi Lue) ； 陳武雄(Jackson Wu-Shoung Chen) ； 陳炯霖(Chiung-Lin Chen)

《Acta Paediatrica Sinica》 9卷4期 (1968/12) Pp. 182-190

摘要

原發性心肌症(Primary myocardial disease)係一種臨床綜合病徵，包括許多不同病因及病態生理學的心肌疾患。其共同的特點為：心臟擴大；通常沒有顯著的心雜音；心電圖呈示左心室肥大或心肌障碍；臨床上除了心肌變化以外，找不出其他器官或全身性疾病。1953年Rosenbaum等，詳查26個本症解剖例，謂其病理變化可歸納為5種：卽心肌炎（包括特發性心肌症），心內膜纖維彈性化症，心臟醣原貯藏症，異源性左側冠狀動脈症及冠狀動脈中層壞死等。著者等認為原護性心肌症，雖不指特殊的疾病，但却是一個臨床上有用而方便的初步診斷名詞。做此診斷以後，可循必要的步驟，去做進一步的診斷並找出共病因來決定其治療方針。

並列摘要

During the 11 years from 1958 to 1968, there were 26 cases of primary myocardial disease admitted to the Department of Pediatrics, National Taiwan University Hospital. Clinically, these cases had some features in common, i.e.: 1). Cardiomegaly with no significant cardiac murmur. 2). Left ventricular hypertrophy and/or myocardial changes seen on the electrocardiograms.
They are further classified into 9 cases of acute myocarditis; 8 cases of idiopathic cardiomyopathy; 2 cases of endocardial fibroelastosis; 3 cases of glycogen storage disease of the heart; 3 cases of anomalous origin of the left coronary artery from the pulmonary artery and 1 case of coronary artery occlusive disease. Complexity of the pathogenesis is reviewed and diagnostic criteria as well as methods of treatment are discussed.