[Ampulla cardiomyopathy with delayed recovery of microvascular stunning: a case report].
A 71-year old woman with schizophrenia was admitted to our hospital on November 26, 2002 under a diagnosis of acute myocardial infarction because of ST segment elevation in leads V2-V5 and positive serum cardiac troponin T level. Emergent coronary angiography showed no significant stenosis, but left ventriculography demonstrated apical ballooning and basal hyperkinesis. The final diagnosis was ampulla cardiomyopathy. Myocardial contrast echocardiography during the acute phase revealed an echocontrast defect consistent with the area of apical ballooning. The condition improved gradually as determined by disappearance of the abnormal wall motion. The coronary flow reserve in the left anterior descending artery measured by transthoracic Doppler echocardiography was decreased at 1.5 in the acute phase and gradually recovered over a period of 3 months (23 days, 1.9; 96 days, 2.9). Microvascular stunning defined as decreased coronary flow reserve was observed and recovery was delayed in this case compared with cases of myocardial stunning. These findings are of interest in evaluating the pathophysiology of ampulla cardiomyopathy.
Cardiovascular Disease Center, Tokyo Metropolitan Police Hospital, Fujimi 2-10-41, Chiyoda-ku, Tokyo 102-8161.
Kazutaka
K
Amaya
Tetsuro
T
Shirai
Tetsu
T
Kodama
Masashi
M
Kasao
Kenji
K
Tsuchida
Kihiro
K
Asano
Kiyoshi
K
Inoue
D000368:Aged; D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017023:Coronary Angiography; D003326:Coronary Circulation; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008833:Microcirculation; D017682:Myocardial Stunning / Q000000981:diagnostic imaging* / Q000209:etiology