Key result
Severe bicuspid aortic stenosis without coronary stenosis can cause circumferential subendocardial infarction, detectable as a perfusion defect on contrast-enhanced CT.
Case Report (n=1)
No
This case demonstrates that severe aortic stenosis can cause circumferential subendocardial infarction even without coronary stenosis, which can be accurately detected as a perfusion defect on contrast-enhanced CT.
Answers are grounded in this paper and cite their sources.
Highlights a non-atherosclerotic etiology for subendocardial ischemia in severe bicuspid.
A 59-year-old man with aortic stenosis (AS) showed cardiopulmonary arrest requiring extracorporeal circulation. Although coronary angiography did not show coronary artery stenosis, he had an elevated creatine kinase-myocardial band value of 1,298 U/L. Echocardiography revealed severe AS and global hypokinesia of the thickened myocardium. Contrast-enhanced computed tomography (CT) detected a circumferential subendocardial perfusion defect of the left ventricular myocardium. Eventually, the patient died from brain anoxia. Autopsy revealed circumferential subendocardial infarction of the left ventricular myocardium. This is the first case of circumferential subendocardial defect on CT corresponding to circumferential subendocardial infarction on autopsy in severe AS without coronary stenosis.
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Akiyama et al. (2022) conducted a case report in Severe bicuspid aortic stenosis (n=1). Severe bicuspid aortic stenosis was evaluated on Subendocardial infarction. Severe bicuspid aortic stenosis without coronary stenosis can cause circumferential subendocardial infarction, detectable as a perfusion defect on contrast-enhanced CT.
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