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Angiology
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Ischemic Cardiomyopathy Without Significant Coronary Stenosis

A Case Report

Nobukazu Ishizaka

Divisions of Cardiology and Pathology, Central Clinical Laboratories, Mitsui Memorial Hospital

Takaaki Isshiki

Divisions of Cardiology and Pathology, Central Clinical Laboratories, Mitsui Memorial Hospital

Fumihiko Saeki

Divisions of Cardiology and Pathology, Central Clinical Laboratories, Mitsui Memorial Hospital

Yuko Ishizaka

Divisions of Cardiology and Pathology, Central Clinical Laboratories, Mitsui Memorial Hospital

Riichilo Takanashi

Divisions of Cardiology and Pathology, Central Clinical Laboratories, Mitsui Memorial Hospital

Tetsu Yamaguchi

Third Department of Internal Medicine, Toho University School of Medicine, Ohashi Hospital, Tokyo, Japan

The authors present a rare case of myocardial infarction in a fifty-eight-year-old man without significant coronary artery stenosis apparent on the emergency coronary angiogram. However, a second angiogram two days later revealed a total occlusion of the left anterior descending artery. Intracoronary thrombolytic therapy was performed with a successful outcome. The patient was subsequently readmitted with an acute myocardial infarction, and the coronary angiogram again failed to demonstrate significant stenosis. Thereafter, the patient's left ventricular function deteriorated progressively, with the occurrence of another myocardial infarction and frequent bouts of symptoms related to congestive heart failure. He died of ischemic cardiomyopathy about seven years later. Findings including an autopsy report showed that myocardial ischemia was involved in the pathogenesis of what initially appeared to be primary dilated cardiomyopathy, based on emergency angiograms.

Angiology, Vol. 46, No. 7, 619-624 (1995)
DOI: 10.1177/000331979504600709
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