Myocardial Damage and Microvasculopathy in a Patient With Systemic Sclerosis

Kawano, Hiroaki; Kudo, Takashi; Umeda, Masataka; Futakuchi, Mitsuru; Sueyoshi, Eijun; Maemura, Koji

doi:10.1253/circj.cj-20-1133

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Circ J

2021

DOI: 10.1253/circj.cj-20-1133

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Myocardial Damage and Microvasculopathy in a Patient With Systemic Sclerosis

Hiroaki Kawano

Takashi Kudo

Masataka Umeda

et al.

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2023

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“…Most intracardiac arteries including atrioventricular nodal artery and arterioles showed fibromuscular dysplastic changes with luminal narrowing ( Figure 3 ) consistent with ischemic pattern LGE in CMRI. Similar to the previous report, 1) the principal pathogenic process in this SSc case was the extensive microvascular occlusion, leading to distinguished ischemic cardiomyopathy from atherosclerotic ischemia.…”

supporting

confidence: 88%

Comprehensive Analysis of the Explanted Systemic Sclerosis Heart: Correlation of Pathologic and Imaging Findings

Lim

Lee

et al. 2023

Korean Circ J

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supporting

confidence: 88%

Comprehensive Analysis of the Explanted Systemic Sclerosis Heart: Correlation of Pathologic and Imaging Findings

Lim

Lee

et al. 2023

Korean Circ J

View full text Add to dashboard Cite

Chest pain and Raynaud’s phenomenon after COVID-19 vaccination in a patient previously diagnosed with systemic lupus erythematosus: a case report

Kawano

Umeda

Okano

et al. 2023

European Heart Journal - Case Reports

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Background Cardiovascular events, including pericarditis, myocarditis, and myocardial ischaemia, have been reported as complications following COVID-19 vaccination. Case summary A 28-year-old Japanese woman diagnosed 10 years earlier with systemic lupus erythematosus (SLE) and antiphospholipid syndrome was admitted to our hospital because of chest pain and Raynaud’s phenomenon. She had received a second dose of the COVID-19 BNT162b2 mRNA vaccine 28 days earlier. 123I-β-methyl iodophenyl pentadecanoic acid (BMIPP) and 201thallium dual myocardial single-photon emission computed tomography demonstrated mildly reduced perfusion of BMIPP in the mid-anterior wall of the left ventricle. Coronary angiography revealed normal coronary arteries; additionally, an endomyocardial biopsy was performed. Histopathological evaluation revealed a normal myocardium without cell infiltration. However, immunostaining for the SARS- CoV/SARS-CoV-2 spike protein was positive in the small intramural coronary arteries. The administration of azathioprine (50 mg/day) and amlodipine (5 mg/day) and increases in her prednisolone (10 mg/day) and aspirin doses led to improvements in the symptoms of the patient. Discussion Our data lead us to speculate that two events in the timeline of the patient, namely receiving COVID-19 vaccination and the presence of SARS-CoV/SARS-CoV-2 spike protein in small intramural coronary arteries, may be related to the myocardial microangiopathy observed in this patient.

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Myocardial Damage and Microvasculopathy in a Patient With Systemic Sclerosis

Cited by 2 publications

References 1 publication

Comprehensive Analysis of the Explanted Systemic Sclerosis Heart: Correlation of Pathologic and Imaging Findings

Comprehensive Analysis of the Explanted Systemic Sclerosis Heart: Correlation of Pathologic and Imaging Findings

Chest pain and Raynaud’s phenomenon after COVID-19 vaccination in a patient previously diagnosed with systemic lupus erythematosus: a case report

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