Article

Journal of Cardiovascular Translational Research

, Volume 6, Issue 5, pp 752-761

First online:

Myocardial Infarction in Sickle Cell Disease: Use of Translational Imaging to Diagnose an Under-Recognized Problem

  • Paul ChackoAffiliated withDavis Heart and Lung Research Institute, The Ohio State University
  • , Eric H. KrautAffiliated withDavis Heart and Lung Research Institute, The Ohio State University
  • , Jay ZweierAffiliated withDavis Heart and Lung Research Institute, The Ohio State University
  • , Charles HitchcockAffiliated withDavis Heart and Lung Research Institute, The Ohio State University
  • , Subha V. RamanAffiliated withDavis Heart and Lung Research Institute, The Ohio State University Email author 

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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.

Keywords

Sickle cell disease Myocardial infarction Ischemic heart disease Microcirculation Magnetic resonance