Reversible cardiac dysfunction (hibernation) from ischemia due to compression of the coronary arteries by a pseudoaneurysm
Article Abstract:
Cardiologists have appropriated the word ''hibernation'' to refer to a chronic functional abnormality of the heart muscle due to ischemia, or oxygen deficiency caused by inadequate blood flow. The key feature of hibernation, in contrast with other heart problems such as infarction, is that the hibernation is at least partially reversible when the cause of the ischemia is relieved. Most reported cases of hibernation have been reported in cardiac patients who have undergone bypass grafting. Patients with severe atherosclerosis sometimes experience an improvement in heart muscle function after grafting improves the blood supply, indicating that the muscle was ''hibernating'' prior to the surgery. Cardiologists now report an unusual case of hibernation which resulted not from atherosclerosis but from a pseudoaneurysm. The present case involves a 67-year-old woman who had been given a mitral valve replacement. Nine weeks after the surgery, the patient developed difficulty breathing. Contrast angiography was performed. This technique, in which opaque material is injected into the blood to make the circulation easily visible on X-rays, revealed the presence of a pseudoaneurysm. The source of the pseudoaneurysm was by the ring of the prosthetic mitral valve; apparently, injury at the site of valve replacement permitted blood to leak from the chamber of the heart into the heart tissue, creating the bulging pseudoaneurysm. The pseudoaneurysm bulged in pulses with the rhythm of the heart, and in doing so pressed on the left main and left anterior descending coronary arteries. These arteries, lying on the outside of the heart, supply the heart muscle with blood. The heart muscle circulation was therefore compromised by the compression of these arteries. The patient's pseudoaneurysm was surgically repaired. A new valve was inserted, and artery bypass grafting was performed at the same time. The patient is now enjoying improved cardiac function and has resumed a moderate exercise program. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1991
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Premature atherosclerosis in patients with familial chylomicronemia caused by mutations in the lipoprotein lipase gene
Article Abstract:
People with chylomicronemia due to mutations in the gene for the enzyme lipoprotein lipase may still be susceptible to atherosclerosis. Chylomicronemia is a condition characterized by elevated blood levels of proteins that carry fats called triglycerides. Researchers used ultrasound and angiography to determine the degree of atherosclerosis in the carotid, coronary and peripheral arteries of 4 people with chylomicronemia. All 4 had a non-functional enzyme. All 4 developed atherosclerosis before age 55 even though they ate a low-fat diet and had low LDL cholesterol levels.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1996
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Arterial abnormalities in the offspring of patients with premature myocardial infarction
Article Abstract:
Structural and functional changes in the coronary arteries may be an indicator of atherosclerosis in teenagers whose parents had a premature heart attack. This was the conclusion of a study of 40 children of patients with premature coronary artery disease.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2000
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