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Progression of coronary microvascular dysfunction to heart failure with preserved ejection fraction: a case report.


ABSTRACT: BACKGROUND:In women with evidence of ischemia and no obstructive coronary artery disease the underlying mechanism is most often attributed to coronary microvascular dysfunction. Higher rates of adverse cardiovascular events, specifically heart failure with preserved ejection fraction, are present in women with coronary microvascular dysfunction, leading to the hypothesis that coronary microvascular dysfunction may contribute to the progression of heart failure with preserved ejection fraction. A 55-year-old, Caucasian woman with a past medical history of chest pain and shortness of breath was referred to our tertiary care center and diagnosed as having coronary microvascular dysfunction by invasive coronary reactivity testing. After 10 years of follow-up care for coronary microvascular dysfunction, she presented to an emergency room in acute heart failure and was diagnosed as having heart failure with preserved ejection fraction. DISCUSSION:The current case report provides a specific example in support of existing studies that demonstrate that coronary microvascular dysfunction may be a precursor of heart failure with preserved ejection fraction. Further research is needed to establish causality and management. TRIAL REGISTRATION:Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02582021 .

SUBMITTER: Joung S 

PROVIDER: S-EPMC6501452 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Progression of coronary microvascular dysfunction to heart failure with preserved ejection fraction: a case report.

Joung Sandy S   Wei Janet J   Nelson Michael D MD   Aldiwani Haider H   Shufelt Chrisandra C   Tamarappoo Balaji B   Berman Daniel D   Thomson Louise E J LEJ   Bairey Merz C Noel CN  

Journal of medical case reports 20190506 1


<h4>Background</h4>In women with evidence of ischemia and no obstructive coronary artery disease the underlying mechanism is most often attributed to coronary microvascular dysfunction. Higher rates of adverse cardiovascular events, specifically heart failure with preserved ejection fraction, are present in women with coronary microvascular dysfunction, leading to the hypothesis that coronary microvascular dysfunction may contribute to the progression of heart failure with preserved ejection fra  ...[more]

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