Idiopathic cystic medial necrosis of the coronary arteries leading to myocardial infarction, old and recent. Clinical pathologic correlation and historical review
Roscher, A.A.; Kato, N.S.; Sambasivan, V.; Proffett, G.
Journal of Cardiovascular Surgery 37(6 Suppl 1: 87-91
1996
ISSN/ISBN: 0021-9509 PMID: 10064357 Document Number: 464753
The reported case study is evidence to the fact that idiopathic cystic medial necrosis occurs more frequently in females, in particular young females, and in association with the post-partum state (female:male ratio 3:1). The case study documents also the fact that early recognition of this syndrome and workup with angiography may lead to a recognition timetable which will allow early diagnosis of ICMN and subsequent treatment with bypass surgery. On the other hand, advanced cases are not suitable for bypass surgery but should be given the benefit of an extensive clinical workup to assess the possibility of benefit of surgical over medical treatment. Of interest is the fact that the patient's father had an acute dissection at the age of 42, involving, however, the aorta, indicating possibly some genetic link.