[Clinical usefulness of 1231I-BMIPP myocardial SPECT in patient with microvascular spasm: a case report].
This patient was a 64-year-old man with chest pain at rest. An electrocardiogram showed depression of the ST segment in V2-V5 leads during chest pain. 123I-BMIPP myocardial SPECT revealed reduced uptake in the apex. Coronary angiographies revealed severely delayed filling of contrast medium without narrowing of epicardial coronary arteries. An intracoronary infusion of isosorbide dinitrate did not improve the delayed filling of contrast medium or the ST segment depression. After an intracoronary infusion of nicorandil, coronary arterial flows were remarkably improved, chest symptoms disappeared, and electrocardiographic findings were improved. Left ventriculography showed severe hypokinesis in the apex. After the medication with nicorandil, reduced 123I-BMIPP myocardial uptake and reduced wall motion on echocardiography were improved. These findings suggest that myocardial ischemia in this case might be explained as having been caused by microcirculation disturbance.
Ito
Kazuki
K
Department of Cardiology, Kouseikai Takeda Hospital.
Kinoshita
Noriyuki
N
Irie
Hidekazu
H
Koide
Masahiro
M
Yokoi
Hirokazu
H
Taniguchi
Takuya
T
Nakamura
Reo
R
Hashimoto
Tetsuo
T
Tamaki
Shunnichi
S
Sawada
Takahisa
T
Azuma
Akihiro
A
Matsubara
Hiroaki
H
D003326:Coronary Circulation; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging* / Q000188:drug therapy; D004562:Electrocardiography; D005227:Fatty Acids; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000188:drug therapy; D020108:Nicorandil / Q000627:therapeutic use; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents / Q000627:therapeutic use
D005227:Fatty Acids; D007462:Iodobenzenes; D014665:Vasodilator Agents; C049338:iodofiltic acid; D020108:Nicorandil