|
|
-Case Reports-
A Case of Myocardial Infarction Caused by Coronary Vasospasm: Efficacy of Soluble Lectin-Like Oxidized LDL Receptor-1 for Distinguishing between Vasospasm and Plaque Rupture
1Division of Intensive Care Unit, Nippon Medical School, Chiba Hokusoh Hospital
2Division of Cardiology, Hepatology, Geriatrics and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School
This case illustrates the benefits of using plasma levels of soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) to distinguish between myocardial injuries caused by coronary vasospasm or coronary plaque rupture. A 62-year-old woman with a history of dyslipidemia was admitted due to chest pain of 1 hour's duration. Electrocardiography demonstrated mild ST segment elevation in leads V1-6, and blood chemistry studies on admission showed a slight increase in the serum level of troponin T; therefore, acute myocardial infarction was diagnosed. However, the plasma level of sLOX-1, a marker of plaque rupture, did not increase during hospitalization. Coronary angiography demonstrated normal coronary arteries, and intracoronary acetylcholine infusion provoked coronary artery vasospasm. We could therefore diagnose myocardial injury caused by coronary vasospasm. We propose that the cause of myocardial injury cannot be predicted with electrocardiography and measurement of troponin T but can be clarified by measuring plasma levels of sLOX-1 in the early stage of acute coronary syndrome.
J Nippon Med Sch 2009; 76: 268-271
Keywords
soluble lectin-like oxidized low-density lipoprotein receptor-1, coronary vasospasm, coronary plaque rupture, acute myocardial infarction
Correspondence to
Nobuaki Kobayashi, MD, Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inba-mura, Inba-gun, Chiba 270-1694, Japan
s5047@nms.ac.jp
Received, July 13, 2009
Accepted, September 9, 2009
PDF (461K)