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Myocardial Infarction Due to Giant Cell Arteritis: A Case Report and Literature Review

源自巨細胞動脈炎的心肌梗塞-病例報告及文獻回顧

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摘要


大部分的巨細胞動脈炎都是發生在頭頸部的動脈,尤其是顯動脈。發生在冠狀動脈的巨細胞動脈炎,並且造成心肌梗塞的病例實在是很罕見。我們這裡報告一個51歲的女性主訴非典型的胸痛,而所給予的檢查均呈擴張性心肌症。雖然經過內科的處理但仍逐漸呈現心臟衰竭,最後給予了心臟移植,病理檢查才發現是局部性冠狀動脈的巨細胞動脈炎。這給我們一個啟示,一般心肌梗塞的病例需將此一罕見的巨細胞動脈炎列入鑑別診斷,因其常有全身的表現。同時我們也回顧了文獻上相同的病例做比較。

並列摘要


Giant cell arteritis occurs mainly in the cranial arteries, especially in the temporal area, and rarely in the coronary arteries. Here, we present a case of coronary artery giant cell arteritis in a 51-year-old woman who complained of atypical chest pain. Radionuclide angiography showed dilated left ventricle with global hypokinesia. Despite medical treatment, she suffered progressive heart failure and finally was given a heart transplant. The pathologic examination revealed myocardial infarction due to coronary giant cell arteritis. Unusual giant cell arteritis should be considered in the differential diagnoses of myocardial infarction.

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