Heart failure with silent coronary artery spasm exhibiting microscopic focal myocardial necrosis and amyloid-deposition.
Intern Med
; 43(3): 199-203, 2004 Mar.
Article
em En
| MEDLINE
| ID: mdl-15098600
ABSTRACT
We report a 67-year-old Japanese man who presented with worsening heart failure with asymptomatically transient ischemic ST-segment depression. Left ventriculography showed diffuse hypokinesis; asymptomatic coronary artery spasm was evoked by the acetylcholine provocation test. Endomyocardial biopsy exhibited hypertrophic cardiomyocytes and scattered microscopic focal myocardial necrosis with amyloid-deposition. Transient ST-segment depression improved after treatment with a calcium antagonist, but cardiac contraction was still impaired. We hypothesize that asymptomatic coronary spasm may cause irreversible cardiac damage and heart failure with amyloid-deposition; the presence or absence of coronary spasm in heart failure patients should be clarified in order to determine therapeutic strategy.
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Base de dados:
MEDLINE
Assunto principal:
Baixo Débito Cardíaco
/
Vasoespasmo Coronário
/
Amiloide
/
Miocárdio
Tipo de estudo:
Etiology_studies
Limite:
Aged
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2004
Tipo de documento:
Article