N. Takahashi et al., ACUTE MYOCARDIAL-INFARCTION ASSOCIATED WITH HYPEREOSINOPHILIC SYNDROME IN A YOUNG MAN, Japanese Circulation Journal, 61(9), 1997, pp. 803-806
The case of a 20-year-old man with acute myocardial infarction is desc
ribed. He developed acute myocardial infarction on 11 July 1995. An em
ergency coronary arteriogram revealed total occlusion of the proximal
left anterior descending coronary artery. Reperfusion was achieved by
intracoronary injection of 6.4x10(6) units of native tissue plasminoge
n activator, which left multiple, angiographically identifiable, throm
bi in the left anterior descending coronary artery. As a coronary angi
ogram 28 days after the onset showed no organic stenosis or wall irreg
ularity, we conducted an ergonovine provocation test. The infusion of
32 mu g of ergonovine into the left coronary artery provoked diffuse,
high-grade vasospasm. The patient's medical history showed that he had
been diagnosed as having Kimura's disease when he was 19 year-old. Ad
ditionally, he had exhibited persistent eosinophilia of unknown origin
for 10 months or more. Thus, his condition was consistent with a diag
nosis of hypereosinophilic syndrome (HES). This is the first report to
document angiographically the presence of acute coronary obstruction
in a patient with HES. The acute coronary occlusion was thought to be
related to coronary artery vasospasm.