Myocardial infarction in sickle cell disease: Use of translational imaging to diagnose an under-recognized problem

Paul Chacko, Eric H. Kraut, Jay Zweier, Charles Hitchcock, Subha V. Raman

Research output: Contribution to journalArticlepeer-review

Abstract

Sickle cell disease (SCD) is an inherited disorder in which microvascular occlusion causes complications across multiple organ systems. The precise incidence of myocardial ischemia and infarction (MI), potentially under-recognized microvascular disease-related complications, remains unknown. The absence of typical atherosclerotic lesions seen in other patients with MI suggests a microvascular mechanism of myocardial injury. Cardiac magnetic resonance (CMR) can demonstrate microvascular disease, making it an appealing modality to assess symptomatic SCD patients. We demonstrate in several dramatic instances how CMR is uniquely able to depict cardiac microvascular obstruction in patients with SCD and chest pain, without which the possibility of myocardial injury would almost certainly be otherwise neglected. Much remains unknown regarding ischemic heart disease in patients with SCD including prevalence, detection, and management. Further work to define evaluation and management algorithms for chest pain in SCD and to develop risk assessment tools may reduce sudden cardiac death in this population.

Original languageEnglish (US)
Pages (from-to)752-761
Number of pages10
JournalJournal of Cardiovascular Translational Research
Volume6
Issue number5
DOIs
StatePublished - Oct 2013
Externally publishedYes

Keywords

  • Ischemic heart disease
  • Magnetic resonance
  • Microcirculation
  • Myocardial infarction
  • Sickle cell disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Genetics
  • Genetics(clinical)
  • Molecular Medicine
  • Pharmaceutical Science

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