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Severe Heart Failure Resulting From Healed Myocardial Infarction Preferentially Involving the Ventricular Septum and

William C Roberts1, Shrita Jayanthi2, Minseob Jeong2

  • 1Baylor Scott & White Heart and Vascular Institute, Baylor University Medical Center, Baylor Scott & White Health, Dallas, Texas; Departments of Internal Medicine and Pathology, Baylor University Medical Center, Baylor Scott & White Health, Dallas, Texas.

The American Journal of Cardiology
|March 10, 2023
PubMed

Insights

Four patients needed heart transplants due to heart failure from healed heart attacks. These attacks, caused by blocked arteries, unusually led to severe scarring in the ventricular septum.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pathology

Background:

  • Heart failure is a significant cause of morbidity and mortality.
  • Orthotopic heart transplantation (OHT) is a life-saving treatment for end-stage heart failure.
  • Myocardial infarction (MI) can lead to heart failure, often due to scarring of the left ventricular free wall.

Observation:

  • This study describes 4 patients who underwent OHT for heart failure.
  • The heart failure was caused by healed acute myocardial infarcts.
  • These infarcts resulted from severe narrowing of the left anterior descending coronary artery.

Findings:

  • Unusually severe scarring of the ventricular septum (VS) was observed in all 4 patients.
  • This VS scarring was more pronounced than that in the left ventricular free wall.
  • The pattern of scarring differed from typical myocardial infarcts secondary to coronary artery narrowing.

Implications:

  • This atypical scarring pattern may have implications for understanding myocardial infarction pathophysiology.
  • Further research is needed to elucidate the mechanisms behind preferential VS scarring.
  • Identifying such patterns could aid in diagnosing and managing specific heart failure etiologies.

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