A Case of Isolated Septal Myocardial Infarction: Myocardial Perfusion-Metabolism Mismatch as a Tool for Diagnosis
Isolated septal myocardial infarction is an uncommon condition with diagnostic difficulty due to small infarction size and anatomical variations. We report a case of isolated septal myocardial infarction, in which the diagnosis was confirmed not by electrocardiographic, echocardiographic, or angiogr...
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Veröffentlicht in: | Oman medical journal 2019-05, Vol.34 (3), p.257-261 |
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Sprache: | eng |
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Zusammenfassung: | Isolated septal myocardial infarction is an uncommon condition with diagnostic difficulty
due to small infarction size and anatomical variations. We report a case of isolated septal
myocardial infarction, in which the diagnosis was confirmed not by electrocardiographic,
echocardiographic, or angiographic findings, but by nuclear imaging. A 46-year-old
man with chest discomfort exhibited ST-segment elevations in leads V1 and V2, and
borderline abnormalities of the septal wall motion on echocardiography. Emergency
coronary angiography demonstrated delayed flow in the second septal branch of the
left anterior descending coronary artery. Intravascular ultrasound showed plaque in the
proximal portion of the septal branch without evidence of plaque rupture. No balloon
angioplasty or stent implantation was required because the flow delay in the septal
branch disappeared after the intravascular ultrasound procedure. Myocardial perfusionmetabolism
mismatch, as assessed by resting thallium-201 and iodine-123-beta-methylp-
iodophenyl-pentadecanoic acid, was seen in the mid-septal region. |
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ISSN: | 1999-768X 2070-5204 |
DOI: | 10.5001/omj.2019.49 |