Diffuse myocardial infarction caused by isolated bilateral coronary ostialstenoses in a young woman: Report of a case

A young Japanese woman who appeared to be free from any coronary risk facto rs was admitted to a local hospital with chest pain. Serological tests show ed no evidence of inflammation; however, an electrocardiogram revealed diff use myocardial ischemia and a coronary angiogram demonstrated isolated bila teral coronary ostial stenoses. Moreover, her serum creatine phosphokinase level was high. On the day following admission, the patient developed sever e cardiogenic shock, and she was transferred to our hospital where emergenc y coronary artery bypass grafting with the saphenous veins was performed us ing retrograde tepid blood cardioplegia. Recovery of cardiac function was i mmediate and her postoperative course was uneventful. We suspect that fibro muscular dysplasia was the most likely cause of the ostial stenoses in this patient.