Clin. Cardiol. 24, 260–263 (2001)
Nikolaos Dagres, M.D., Michael Haude, M.D., Dietrich Baumgart, M.D., Stefan Sack, M.D., Raimund Erbel, M.D., FACC, FESC
Department of Cardiology, Center of Internal Medicine, University of Essen, Essen, Germany
Summary: Patients with Guillain-Barré syndrome often have cardiac disturbances as a manifestation of autonomic dysfunction. Such abnormalities consist of arrhythmias and disturbances of heart rate and blood pressure. We report a case of a patient with Guillain-Barré syndrome who developed ST-segment elevation in the inferolateral leads, suggestive of an acute coronary syndrome. Cardiac catheterization revealed angiographically normal coronary arteries. Intracoronary ultrasound was also normal. Intracoronary Doppler flow measurements revealed an elevated baseline coronary flow velocity of up to 41 cm/s and decreased coronary flow reserve, particularly in the left circumflex artery. Myopericarditis as cause of the electrocardiographic changes could be ruled out by echocardiography and endomyocardial biopsy. We postulate that the intracoronary Doppler findings are caused by autonomic dysfunction with decrease of coronary resistance and redistribution of the transmural myocardial blood flow.
Key words: intracoronary Doppler, coronary flow velocity reserve, Guillain-Barré syndrome
Address for reprints:
Dr. Nikolaos Dagres
Abteilung fuer Kardiologie, Medizinische Klinik
Universitaetsklinikum Essen
Hufelandstr. 55
45122 Essen, Germany
Received: May 27, 1999
Accepted with revision: October 13, 1999