A Case of ST-Elevated Myocardial Infarction Resulting From Obstructive Intramural Coronary Amyloidosis
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概要
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A 49-year-old man presenting with ST-elevated myocardial infarction was brought to our emergency department with AL amyloidosis. Baseline coronary angiography showed no significant stenosis of the epicardial coronary arteries, however, coronary artery angiography in response to acetylcholine and coronary flow reserve in response to papaverine were abnormal, which suggested impairment of vascular endothelial function. Myocardial biopsy revealed amyloid deposition exclusively in intramural coronary arteries. Early amyloidosis without myocardial involvement can produce acute coronary syndrome through the combination of spastic epicardial coronary arteries and obstruction of the intramural coronary arteries. In the management of certain patients with acute coronary syndrome, the possibility of cardiac amyliodosis should be taken into consideration.
著者
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Aoyagi Teruhiko
Department Of Cardiovascualr Medicine Japanese Red Cross Medical Center
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Uozumi Hiroki
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo School Of Medi
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Shiraishi Junichi
Department Of Pathology And Immunology Aging And Developmental Sciences Tokyo Medical And Dental Uni
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Takemura Tamiko
Department Of Pathology Japan Red Cross Medical Center
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Soma Katsura
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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Soma Katsura
Department of Cardiovascular Medicine, Japanese Red Cross Medical Center
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Kobayakawa Naoshi
Department of Cardiovascular Medicine, Japanese Red Cross Medical Center
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KOBAYAKAWA Naoshi
Department of Cardilogy, Japanese Red Cross Medical Center, Second Department of Internal Medicine, University of Tokyo, Tokyo, Japan.
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Takizawa Masataka
Department of Cardiovascular Medicine, Japanese Red Cross Medical Center
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