• Internal medicine · Apr 2023

    Case Reports

    Subendocardial Infarction in Severe Bicuspid Aortic Stenosis without Coronary Stenosis Confirmed by Contrast-enhanced Computed Tomography and Autopsy.

    • Takumi Akiyama, Yuki Okoshi, Toshiki Takano, Tsuyoshi Yoshida, Yasuhiko Tanabe, and Takayuki Inomata.
    • Department of Cardiovascular Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan.
    • Intern. Med. 2023 Apr 15; 62 (8): 118111831181-1183.

    AbstractA 59-year-old man with aortic stenosis (AS) showed cardiopulmonary arrest requiring extracorporeal circulation. Although coronary angiography did not show coronary artery stenosis, he had an elevated creatine kinase-myocardial band value of 1,298 U/L. Echocardiography revealed severe AS and global hypokinesia of the thickened myocardium. Contrast-enhanced computed tomography (CT) detected a circumferential subendocardial perfusion defect of the left ventricular myocardium. Eventually, the patient died from brain anoxia. Autopsy revealed circumferential subendocardial infarction of the left ventricular myocardium. This is the first case of circumferential subendocardial defect on CT corresponding to circumferential subendocardial infarction on autopsy in severe AS without coronary stenosis.

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