title: Myocardial infarction in sickle cell disease: use of translational imaging to diagnose an under-recognized problem.
abstract: Sickle cell disease (SCD) is an inherited disorder in which microvascular occlusion causes complications across multiple organ systems. The precise incidence of myocardial ischemia and infarction (MI), potentially under-recognized microvascular disease-related complications, remains unknown. The absence of typical atherosclerotic lesions seen in other patients with MI suggests a microvascular mechanism of myocardial injury. Cardiac magnetic resonance (CMR) can demonstrate microvascular disease, making it an appealing modality to assess symptomatic SCD patients. We demonstrate in several dramatic instances how CMR is uniquely able to depict cardiac microvascular obstruction in patients with SCD and chest pain, without which the possibility of myocardial injury would almost certainly be otherwise neglected. Much remains unknown regarding ischemic heart disease in patients with SCD including prevalence, detection, and management. Further work to define evaluation and management algorithms for chest pain in SCD and to develop risk assessment tools may reduce sudden cardiac death in this population.
authors.affiliation: Davis Heart and Lung Research Institute, The Ohio State University, 473 W. 12th Ave, Suite 200, Columbus, OH, 43210, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Chacko
authors.forename: Eric H
authors.initials: EH
authors.lastname: Kraut
authors.forename: Jay
authors.initials: J
authors.lastname: Zweier
authors.forename: Charles
authors.initials: C
authors.lastname: Hitchcock
authors.forename: Subha V
authors.initials: SV
authors.lastname: Raman
mesh_terms: D000755:Anemia, Sickle Cell / Q000150:complications*; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008833:Microcirculation; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012307:Risk Factors; D057170:Translational Research, Biomedical