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Characteristic clinical findings of reversible left ventricular dysfunction
Toshihiko Yamasa1, Satoshi Ikeda, Akiyo Ninomiya
1Department of Cardiology, Sasebo Municipal General Hospital, Nagasaki.
Internal Medicine (Tokyo, Japan)
|November 5, 2002
Summary
Reversible left ventricular dysfunction (RLVD) mimics heart attacks but is more common in women and may involve autonomic nerves or coronary artery sensitivity, not typical atherosclerosis.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Reversible left ventricular dysfunction (RLVD) presents symptoms mimicking acute myocardial infarction.
- Patients exhibit apical akinesis or dyskinesis without coronary artery abnormalities.
Purpose of the Study:
- To evaluate clinical findings in patients with RLVD.
- To explore potential etiologies of RLVD, differentiating it from typical ischemic heart disease.
Main Methods:
- Clinical data from 16 RLVD patients were analyzed.
- Electrocardiogram (ECG) changes and serum cardiac markers were assessed.
- Coronary artery evaluation and spasm provocation tests were performed.
Main Results:
- RLVD occurred predominantly in women (1:7 male to female ratio).
- ECG showed ischemic changes; cardiac markers were minimally elevated.
- Histological examination revealed no specific myocardial changes; most spasm tests were negative.
Conclusions:
- RLVD may represent an atypical ischemic heart disease, potentially linked to autonomic dysfunction or transient coronary artery hypersensitivity.
- The higher prevalence in women and negative coronary findings suggest mechanisms beyond severe coronary arteriosclerosis.
- Positive spasm tests in a subset indicate a role for factors transiently increasing coronary artery sensitivity.