脳梗塞に加えて心筋梗塞を4回発症したホモシステイン血症の1例

Abstract

We report a 50-year-old man with homocysteinemia who had a cerebral infarction and recurrent myocardial infarction. His coronary risk factors were smoking and homocysteinemia. A cerebral infarction had occurred when he was 34 years old, and his first myocardial infarction occurred in 1988. Coronary angiography performed at Nara Medical University on the first admission in 1989 showed a 50% stenosis in the mid-left anterior decending artery (LAD) and a 75% stenosis in the distal-left circumflex artery (LCX). The latter lesion was dilated to a 25% stenosis by percutaneus transluminal coronary angioplasty (PTCA). A second myocardial infarction occurred in 1990. The mid -LAD showed a total occlusion and was dilated to a 25% stenosis by PTCA. A third myocardial infarction occurred in 1995. Again, the mid-LAD had a total occlusion and was dilated to a 25% stenosis by PTCA. There was no history of recent angina pectoris, but the patient had a fourth myocardial infarction in 1996. A total occlusion was dilated in the LCX (seg 15). This lesion was dilated to a 25% stenosis by PTCA. This was a rare case of homocysteinemia complicated by cerebral infarction and recur- rent myocardial infarction.