Journal
JOURNAL OF MEDICAL CASE REPORTS
Volume 13, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s13256-019-2074-z
Keywords
Coronary microvascular dysfunction; Heart failure with preserved ejection fraction; Non-obstructive coronary artery disease; Cardiac magnetic resonance imaging
Categories
Funding
- National Heart, Lung and Blood Institute (NHLBI) [N01HV68161, N01HV68162, N01HV68163, N01HV68164, U01HL64829, U01HL64914, U01HL64924, K23HL105787, T32HL69751, R01HL090957, R01HL33610, R01HL56921, UM1HL087366]
- National Institute on Aging (NIA) [R03AG032631]
- National Center for Research Resources (NCRR) [M01RR000425]
- National Center for Advancing Translational Sciences (NCATS) [UL1TR000124, UL1TR000064, UL1TR001427]
- Gustavus and Louis Pfeiffer Research Foundation, Danville, NJ
- Ladies Hospital Aid Society of Western Pennsylvania, Pittsburgh, PA
- Society for Women's Health Research (SWHR), Washington, D.C.
- QMED, Inc., Laurence Harbor, NJ
- Women's Guild of Cedars-Sinai
- Edythe L. Broad
- Constance Austin Women's Heart Research Fellowships
- Barbra Streisand Women's Cardiovascular Research and Education Program
- Linda Joy Pollin Women's Heart Health Program
- Erika J. Glazer Women's Heart Research Initiative
- Adelson Family Foundation, Cedars-Sinai Medical Center, Los Angeles, CA
- Gatorade Trust
- PCORnet-One Florida Clinical Research Consortium, University of Florida, Gainesville, FL [CDRN-1501-26692]
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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.
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