Dynamic intraventricular obstruction in acute myocardial infarction with administration of cilostazol.
Dynamic intraventricular obstruction is a less well-known mechanical complication of acute myocardial infarction (AMI). Its hallmark is the development of a new systolic murmur, and echocardiography is necessary for diagnosis. We describe a case of a 74-year-old woman with dynamic intraventricular obstruction complicating AMI. Serial echocardiography suggested that the intraventricular gradient was a consequence of basal hyperkinesis, which was a reciprocal response to akinesis of the apical wall. Cilostazol, which was administered to prevent subacute stent thrombosis after percutaneous coronary intervention, might have contributed to the transient intraventricular obstruction.
Ozaki
Kazuyuki
K
Department of Cardiology, Niigata City General Hospital. k-ozaki@hosp.niigata.niigata.jp
Maeda
Chiyo
C
Takayama
Tsugumi
T
Hoyano
Makoto
M
Yanagawa
Takao
T
Tsuchida
Keiichi
K
Takahashi
Kazuyoshi
K
Miida
Tsutomu
T
Oda
Hirotaka
H
D000208:Acute Disease; D000368:Aged; D000077407:Cilostazol; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000517:prevention & control; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D015607:Stents / Q000009:adverse effects; D013777:Tetrazoles / Q000009:adverse effects* / Q000627:therapeutic use; D014694:Ventricular Outflow Obstruction / Q000139:chemically induced* / Q000175:diagnosis*
D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077407:Cilostazol