Key result
Two patients with chronic Chagas' cardiomyopathy developed acute myocardial infarction with normal coronary arteries, possibly due to embolic events, coronary thrombosis, or coronary spasms.
Case Report (n=2)
Acute myocardial infarction can occur in patients with chronic Chagas' cardiomyopathy in the absence of obstructive coronary artery disease, potentially due to embolism, thrombosis, or spasm.
This report describes two patients with chronic Chagas' Heart Disease who developed clinical and laboratorial signs of myocardial infarction. Both patients presented sudden oppressive chest pain, without precipitating factor. In the first case, the highest MB-CK value was 65 IU, 22 hours after the beginning of the pain. On the second case, it was 77 IU at 18 hours after the beginning of the pain. In both cases ECG changes suggesting non-transmural infarction were present. The 99mTc PYP myocardial scintigram of the first case was positive. Coronary angiograms performed on the 18th and 9th day, respectively, after the acute infarction did not display obstructive lesions. Possible mechanisms causing myocardial infarction with normal coronary arteries in Chagas' Disease may include: embolic event's, particularly when there is associated congestive heart failure; coronary thrombosis and coronary spasms.
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Lage et al. (1986) conducted a case report in Chronic Chagas' Heart Disease with acute myocardial infarction (n=2). Chronic Chagas' cardiomyopathy was evaluated on Clinical and laboratorial signs of myocardial infarction without obstructive coronary lesions. Two patients with chronic Chagas' cardiomyopathy developed acute myocardial infarction with normal coronary arteries, possibly due to embolic events, coronary thrombosis, or coronary spasms.
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