No abstract

A patient with the Marfan syndrome and echocardiographic and angiocardiographic evidence of hypertrophic cardiomyopathy is presented. Endomyocardial biopsy was performed. Histologic abnormalities of the endomyocardium noted in this patient were considered to be related to the basic generalized connective tissue abnormality, and the patient subsequently developed myocardial disease compatible with hypertrophic non-obstructive cardiomyopathy. We believe that this case emphasizes the possible coexistance of subclinical myocardial disease in patients with the Marfan syndrome.

SUMMARYA case of a 3-month-old male infant with myocardial infarction due to left coronary ostial stenosis is presented.Clinically it was quite similar to anomalous origin of the left coronary artery.Aortogram demonstrated hypoplastic left coronary artery.Postmortem examination revealed quite narrow left coronary ostium and myocardial infarction with aneurysm of the left ventricular apex. AdditionalIndexing Words: Myocardial infarction Coronary ostial stenosis M YOCARDIAL infarction in infancy is rare and may result from one of the several conditions. Aberrant left coronary artery from the pulmonary artery may be the most common cause of myocardial infarction in infancy.1) Recently in Japan acute febrile mucocutaneous lymph node syndrome2),3) is attracted attention as a cause of myocardial infarction in infancy. This report presents an infant who suffered from myocardial infarction due to left coronary ostial stenosis which was clinically similar to anomalous origin of the left coronary artery from the pulmonary artery. CASE REPORTA 10-day-old Japanese male infant was admitted to Nihon University Hospital because of convulsion. He was delivered from a 22-year-old mother at 39 weeks' gestation by Cesarian section because of breech presentation. His birth weight was 2,550Gm. He had been well until 6 days old when he developed convulsion and was admitted to the hospital. Serum calcium level was 7.2mg/100ml, phosphate From the

Oral administration of prostaglandin E2 resulted in marked clinical and hemodynamic improvement in patients with hypoplastic left heart syndrome. A lessening of metabolic acidosis and an increase in blood pressure were evident. These results indicate that the ductus arteriosus was effectively dilated by oral prostaglandin E2 in patients with ductus-dependent systemic circulation, as in the case of ductus-dependent pulmonary circulation. Surgical risk will also be reduced by pretreatment with oral prostaglandin E2.

From 1986 to 1989, seven children ranging in age from 5 months to 16 years underwent surgical treatment for the Wolff-Parkinson—White syndrome at the Shiga University of Medical Science. None of the patients had any other associated congenital heart disease. There was a right free wall accessory pathway in four patients and a left free wall accessory pathway in three. Surgical ablation of these accessory pathways was performed on eight occasions, using the endocardial approach three times and the epicardial approach five. All the children are alive and none has since had episodes of tachycardia. Only one patient had a recurrent delta wave, which was noted 18 months after the operation. Surgical ablation of the accessory pathway for the Wolff-Parkinson—White syndrome can be performed safely, even in infants and children; it is concluded that this useful procedure is capable of improving a patient's quality of life.