ISCHEMIC CARDIOMYOPATHY WITHOUT SIGNIFICANT CORONARY STENOSIS - A CASE-REPORT

The authors present a rare case of myocardial infarction in a fifty-ei ght-year-old man without significant coronary artery stenosis apparent on the emergency coronary angiogram. However, a second angiogram two days later revealed a total occlusion of the left anterior descending artery. Intracoronary thrombolytic therapy was performed with a succes sful outcome. The patient was subsequently readmitted with an acute my ocardial infarction, and the coronary angiogram again failed to demons trate significant stenosis. Thereafter, the patient's left ventricular function deteriorated progressively, with the occurrence of another m yocardial infarction and frequent bouts of symptoms related to congest ive heart failure. He died of ischemic cardiomyopathy about seven year s later. Findings including an autopsy report showed that myocardial i schemia was involved in the pathogenesis of what initially appeared to be primary dilated cardiomyopathy, based on emergency angiograms.