Ebstein's anomalyに合併した急性心筋梗塞症の1例

A case of acute myocardial infarction complicated with Ebstein's anomaly

　Ebstein's anomalyはまれな心奇形の1つであり，その発生頻度は，先天性心疾患の1％以下といわれている^1）。その自然予後は比較的悪く，Makous^2）らによれば219例のEbstein's anomalyのうち，死亡した86例の死亡時平均年齢は20歳である。またBoncroftによる同疾患のlife expectancyは男性33歳，女性39歳，全体で37歳であり，40歳以上に達するのは4.6〜8.7％にすぎない^2,4）。したがって，本疾患に急性心筋梗塞症（AMI）を合併する頻度はきわめて低いと考えられ，心筋梗塞を含む動脈硬化性心疾患合併例の報告は皆無に近い。最近我々は，Ebstein's anomalyにAMIを合併した，きわめてまれな1例を経験したので報告する。

Ebstein's anomaly is a rare congenital heart disease and its prognosis is poor. Bancroft and Makous reported that the life expectancy at birth was 37 years and less than 8.7% of the patientswith Ebstein's anomaly could survive more than 40 years. These findings suggest minimal chances for these patients to have myocardial infarction. In fact no such cases have been reported in the literature. In this report we presented a patient with Ebstein's anomaly associated with acute myocadial infarction.

The patient was a 50 year-old male. He was first noticed to have heart murmur at the age of 3 years, but he had been in good health until 40 years of age when he had episodes of palpita-tion and syncope, and a diagnosis of W-P-W syndrome (type B) was made.