Two patients with acute reversible wall motion abnormalities after noncardiac disease demonstrated reduced coronary flow reserve and regional defects on cardiac scintigraphy.
Case Report (n=2)
Microvascular dysfunction and sympathetic nervous abnormalities may underlie acute reversible left ventricular wall motion abnormalities (stress cardiomyopathy) triggered by noncardiac disease.
Acute reversible left ventricular wall motion abnormalities mimicking myocardial stunning have been reported with noncardiac disease and their coronary angiograms did not demonstrate organic stenosis or vasospasm in the epicardial coronary arteries. Thus, this mechanism has not yet been fully clarified. Two patients are reported as demonstrating acute reversible wall motion abnormalities after noncardiac disease. The electrocardiographic and echocardiographic findings mimicked myocardial stunning and confirmed the previous reports. The coronary angiograms did not show any corresponding coronary stenosis or vasospasm, but did show a reduced coronary flow reserve. Cardiac metaiodobenzylguanidine scintigraphy demonstrated regional defects involving the apex, a decreased heart/mediastinum ratio and an enhanced washout rate, which partially returned to normal after 3 months. Microvascular dysfunction and sympathetic nervous abnormalities might be responsible for the reversible contractile impairment.
Sadamatsu et al. (2000) conducted a case report in Acute reversible left ventricular wall motion abnormalities after noncardiac disease (n=2). Noncardiac disease was evaluated on Coronary flow reserve and cardiac metaiodobenzylguanidine scintigraphy findings. Two patients with acute reversible wall motion abnormalities after noncardiac disease demonstrated reduced coronary flow reserve and regional defects on cardiac scintigraphy.