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Open Access 01-12-2019 | Magnetic Resonance Imaging | Case report

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

Authors: Sandy Joung, Janet Wei, Michael D. Nelson, Haider Aldiwani, Chrisandra Shufelt, Balaji Tamarappoo, Daniel Berman, Louise E. J. Thomson, C. Noel Bairey Merz

Published in: Journal of Medical Case Reports | Issue 1/2019

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.

Case summary

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.

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Title: Progression of coronary microvascular dysfunction to heart failure with preserved ejection fraction: a case report
Authors: Sandy Joung
Janet Wei
Michael D. Nelson
Haider Aldiwani
Chrisandra Shufelt
Balaji Tamarappoo
Daniel Berman
Louise E. J. Thomson
C. Noel Bairey Merz
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Dyspnea
Nitroglycerin
Heart Failure
Dyspnea
Arterial Diseases
Published in: Journal of Medical Case Reports / Issue 1/2019
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-019-2074-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background

Case summary

Discussion

Trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case summary

Discussion

Trial registration

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