Japanese Journal of Electrocardiology
Online ISSN : 1884-2437
Print ISSN : 0285-1660
ISSN-L : 0285-1660
Volume 37 , Issue 2
Showing 1-17 articles out of 17 articles from the selected issue
  • Hiroaki Yamamoto, Chieko Itamoto, Hideo Miura, Minato hayashi, Tunesuk ...
    2017 Volume 37 Issue 2 Pages 63-70
    Published: July 06, 2017
    Released: April 16, 2018

    A 71 year-old woman was admitted to our hospital because of chest pain. She had been suffering from diabetes mellitus since age 30. Electrocardiography and echocardiography showed left ventricular hypertrophy. Coronary angiography showed significant stenosis at the left anterior descending artery, and we performed percutaneous coronary intervention successfully. We diagnosed her case as familial hypertrophic cardiomyopathy with angina pectoris because she has had many relatives with heart disease, though not diabetes nor deafness. After 8 years, her electrocardiography changed gradually and drastically, becoming precordial lead to QS pattern, and she also had mild deafness, suggesting mitochondrial disease. We investigated mitochondrial 3243 mutation and found two percentage heteroplasmy. Combined with cardiac magnetic resonance imaging that showed extensive myocardial defect, we confirmed the diagnosis of her disease as mitochondrial cardiomyopathy. We speculated her angina not only representing diabetic atherosclerosis but also implicating vascular smooth muscle dysfunction due to mitochondrial disease. Precordial QS pattern may suggest a diagnosis of mitochondrial cardiomyopathy.

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