Japanese Heart Journal
Online ISSN : 1348-673X
Print ISSN : 0021-4868
ISSN-L : 0021-4868
Case Reports
Reversible Left Ventricular Systolic Dysfunction -Reversibility of Coronary Microvascular Abnormality
Junya AkoKatsu TakenakaKansei UnoFumitaka NakamuraTsuyoshi ShojiKatsuya IijimaYumiko OhikeSeungbum KimTokumitsu WatanabeMasao YoshizumiYasuyoshi Ouchi
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2001 Volume 42 Issue 3 Pages 355-363

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Abstract

Reversible left ventricular wall motion abnormalities mimicking myocardial infarction have been reported in patients with a noncardiac illness. Their coronary angiograms do not demonstrate organic stenosis or epicardial coronary vasospasm. In this article, two cases of reversible left ventricular contraction abnormality are presented. Electrocardiography showed deep inverted T waves in precordial leads, and the echocardiography revealed diffuse akinesis of the apical region in the acute phase. Coronary angiography showed no significant stenosis or occlusion in either patient. Thallium scintigraphy showed no defect, while the metaiodobenzylguanidine scintigraphy demonstrated significant defects in the apex. The relative coronary flow reserve ratio, measured with an intracoronary Doppler flow wire, was significantly reduced in both patients. Myocardial contrast echocardiography revealed a reversible perfusion defect in the apex in the acute phase in case 2. Transiently impaired coronary microcirculation was thought to be involved in the pathogenesis of the reversible left ventricular dysfunction observed in these patients.

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© 2001 by the Japanese Heart Journal
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