Extensive myocardial stunning showing transient regression of prolonged T wave inversion and prolonged sympathetic denervation.
A 69-year-old woman was admitted to the hospital with palpitations. Although left ventriculography showed extensive akinesis except in the basal hyperkinetic segment, coronary angiography showed normal coronary arteries. 123I-metaiodobenzylguanidine (MIBG) accumulation was obviously reduced in the anteroseptal, apical and inferior areas. Inverted T waves developed on day 3 and disappeared on day 104 after transient regression. Echocardiography showed normal left ventricular motion two weeks later. Ergonovine provocation test showed no vasospasm and thallium-201 showed no perfusion defect on day 46. Electrocardiography and MIBG returned to normal on day 216. These findings suggest prolonged sympathetic nerve injury in extensive myocardial stunning.
Sato
T
T
Department of Cardiovascular Medicine, Matsuyama City Hospital, Matsuyama.
Tani
Y
Y
Fujieda
H
H
Murao
S
S
Sato
H
H
D019797:3-Iodobenzylguanidine; D000368:Aged; D001794:Blood Pressure; D004452:Echocardiography; D004562:Electrocardiography; D004874:Ergonovine; D005260:Female; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging / Q000294:innervation* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D017682:Myocardial Stunning / Q000175:diagnosis / Q000503:physiopathology*; D019275:Radiopharmaceuticals; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D013610:Tachycardia / Q000209:etiology; D016277:Ventricular Function, Left
D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D004874:Ergonovine