AN ELDERLY CASE OF ISCHEMIC CARDIOMYOPATHY WITH SUCCESSFUL IMPROVEMENT IN LEFT VENTRICULAR FUNCTION AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

Abstract

A 76-year-old woman was admitted to our hospital because of dyspnea and palpitation. A 12-lead EGG showed ventricular premature beats, but no evidence of old or new myocardial infarction. Chest X-ray showed pulmonary congestion and an increased cardio-thoracic ratio. Echocardiogram showed severe left ventricular chamber dilatation and diffuse hypokinesis of the left ventricular wall. The results of these noninvasive diagnostic procedures suggested dilated cardiomyopathy. On the twelfth hospital day, the patient developed chest pain with increased serum creatinine phosphokinase. Emergency cardiac catheterization was performed, and severe three-vessel disease was revealed. Staged PTCA was performed for all three vessels. One month after complete revascularization of the three vessels, the left ventriculography showed that left ventricular ejection fraction had improved to 49 % from 26 % at admission. In elderly patients with severe generalized poor left ventricular wall motion, in whom ischemic cardiomyQpathy rather than dilated cardiomyopathy can be ruled out, PTCA should be considered as a treatment modality.