Abnormal electrocardiogram in a patient with amyotrophic lateral sclerosis mimicking myocardial ischaemia

作     者：Juana Martínez César Ramón César Morís Julio Pascual Germán Morís 

作者机构：Neurology Department Hospital Universitario Central Asturias Cardiology Department Hospital Universitario Central Asturias 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2014年第2卷第6期

页      面：211-214页

核心收录：

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：Amyotrophic lateral sclerosis Autonomic nervous system diseases Electrocardiography Myocardial ischemia Cardiac catheterization 

摘      要：Amyotrophic lateral sclerosis(ALS) is a progressive neurodegenerative disorder that almost exclusively involves motor neurons although autonomic dysfunction has also been reported. We present an 84-year-old female with no documented history of heart disease, who was admitted with negative T waves in the electrocardiogram precordial leads mimicking myocardial ischaemia. No other abnormalities were shown in the rest of the cardiologic evaluation, suggesting autonomic nervous system dysfunction. A neurophysiological study demonstrated acute and chronic denervation in multiple muscles with normal nerve conduction studies, confirming ALS diagnosis. Previous studies have shown that subclinical sympathetic hyperfunction and parasympathetic hypofunction might result in cardiovascular dysfunction in ALS patients. It is important to detect disturbances of autonomic cardiac control because this dysfunction may influence survival and quality of life, leading to a decrease in life expectancy in ALS patients.This Case Report may support the impairment of cardiac autonomic control in patients with ALS.