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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

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[An elderly case of triple-vessel coronary artery disease with alternating bundle branch blocks in serial

H Kawata1, A Kawamoto, M Watanabe

  • 1First Department of Internal Medicine, Nara Medical University.

Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
|December 30, 1999
PubMed

Insights

An elderly patient experienced congestive heart failure and alternating bundle branch blocks, linked to aging, post-myocarditis, and severe coronary artery disease.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Congestive heart failure (CHF) presents a significant clinical challenge, particularly in the elderly.
  • Myocarditis and coronary artery disease (CAD) are common etiologies of cardiac dysfunction.

Observation:

  • An 82-year-old woman presented with acute CHF, chest pain, and peripheral cyanosis.
  • Echocardiography revealed severe left ventricular hypokinesis, and serial ECGs showed transient alternating bundle branch blocks.
  • Endomyocardial biopsy indicated chronic myocarditis, not acute, with myocyte changes and fibrosis.

Findings:

  • The patient was diagnosed with CHF and triple-vessel coronary artery disease (CAD).
  • Transient alternating bundle branch blocks were observed, suggesting significant cardiac electrical instability.
  • The combination of aging, post-myocarditic changes, and severe CAD likely contributed to the diffuse left ventricular dysfunction.

Implications:

  • This case highlights the complex interplay of factors contributing to heart failure in the elderly.
  • Understanding these multifactorial causes is crucial for effective management and treatment strategies.
  • The findings underscore the importance of comprehensive cardiac evaluation, including angiography and biopsy, in complex cases.

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