[An autopsy case developing both marked stenosis of the coronary artery and dilated phase of hypertrophic cardiomyopathy].

A Yamada, S Nakamoto, M Sakamoto, T Matsumoto
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Abstract

An autopsy case involving the dilated phase of hypertrophic cardiomyopathy (HCM) is reported. This case was also complicated with a lesion similar to fibromuscular dysplasia of the coronary artery. A 37 year-old male died of cardiac insufficiency and an autopsy was performed. Macroscopically, both atriums and ventricles were dilated and the walls of both ventricles were markedly thickened. Also, the coronary artery was almost completely obstructed. Histological examination revealed bizarre myocardial hyperplasia with disorganization and marked fibrosis of the myocardium. The coronary artery showed intimal fibrous thickening with increase in elastic fibers and smooth muscle cells. There were similar lesions in other arteries examined; the renal arteries, external iliac arteries, pulmonary arteries and aorta. We think that this lesion of the coronary artery plays an important part in the progression from hypertrophic cardiomyopathy to dilated cardiomyopathy.

[尸检同时出现冠状动脉明显狭窄和肥厚性心肌病扩张期的病例]。
一例涉及扩张期肥厚性心肌病(HCM)的尸检报告。该病例还合并了类似于冠状动脉纤维肌肉发育不良的病变。一名37岁男性死于心功能不全,并进行了尸检。宏观上,心房和心室均扩张,心室壁明显增厚。此外,冠状动脉几乎完全阻塞。组织学检查显示心肌奇异增生,组织紊乱,心肌纤维化明显。冠状动脉内膜纤维增厚,弹性纤维和平滑肌细胞增多。其他动脉也有类似病变;肾动脉,髂外动脉,肺动脉和主动脉。我们认为这种冠状动脉病变在肥厚型心肌病向扩张型心肌病发展的过程中起着重要的作用。
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