Myocardial Necrosis with Normal Left VentricularFunction

Overview

The authors draw attention to the fact that myocardial necrosis need not necessarily developon the basis of coronary atherosclerosis. On an actual case they demonstrate the rare occurrenceof its development on the background of florid thyrotoxicosis. Necrosis of the myocardium ofthis origin was confirmed by the dynamics of cardiospecific enzymes and currently by tomo-graphic scintigraphy of the myocardium with 99m Tc-methylene diphosphonate. However, a di-sorder of the total left ventricular function was not proved nor of the regional kinetics byechocardiographic examination or left-sided ventriculography. It may be therefore assumedthat disperse affection of the heart muscle in thyrotoxicosis leads only to focal intramuralnecroses of myocardial cells as suggested also by the results of perfusion scintigraphy of theheart muscle with 99m Tc-MIBI Cardiospect which proved uneven perfusion of the myocardiumbut at the same time its total viability.

Key words:
myocardial necrosis - thyrotoxicosis - left ventricular function.