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Published on: June 14, 2016
Microvascular dysfunction and cardiac fibrosis in heart failure with preserved ejection fraction: a case report
Nikhil Narang1, Diego Medvedofsky1, Kathryn Dryer2
1Section of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, 60637, USA.
Abstract:
We report the case of a 55-year-old woman with heart failure with preserved ejection fraction (HFpEF), who presented with hypertensive urgency and pulmonary oedema. The patient was medically optimized and underwent cardiac catheterization revealing pulmonary hypertension, elevated pulmonary capillary wedge pressure, normal cardiac index, and non-obstructive coronary disease. Invasive evaluation of coronary flow revealed blunted coronary flow reserve and increased index of microvascular resistance. Cardiac magnetic resonance imaging demonstrated reduced global myocardial perfusion and diffuse interstitial fibrosis. This case exhibits a potential HFpEF phenotype associated with microvascular dysfunction, fibrosis, and elevated filling pressures.
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