123I-MIBGの心集積がみられないシンドロームX症例について

A Case of Syndrome X in which Absence of Mvocardial 123I-MIBG Accumulation was Demonstrated

　シンドロームX患者の一部では交感神経機能異常が関係すると推定されている．62歳，女性で，胸痛とST低下が出現する興味あるシンドロームX症例を報告する．²⁰¹T1と¹²³I—BMIPP心筋シンチグラムでは，前壁，中隔，下壁，心尖部などに軽度の異常がみられた．冠動脈に狭窄はなく，エルゴノビン負荷による冠攣縮も誘発されなかった．¹²³I-MIBG心筋シンチグラムでは心筋に¹²³I-MIBGの集積はみられず，カルシウム拮抗薬投与4カ月後に突然死した．

Presence of sympathetic nerve dysfunction is suspect-ed in some patients who have a history of chest pain, but who have angiographically normal coronary arteries, namely syndrome X. A 62-year old woman was admitted to our hospital because of exertional angina. An anginal chest pain appeared after treadmill exercise test with ST depression at V_1-4.²⁰¹ T1 and ¹²³I- BMIPP scintigrams showed slight abnormal imaging at the anterior, septal, inferior wall or apex. There was no significant stenosis in either of the coronary arteries and, no vasospasm was induced with ergonovine-provocated coronary angiography. Myocardial ¹²³I-MIBG accumu lation was absent in this patient, and she died suddenly after a four-month calcium antagonist treatment.