Ultrastructural changes resembling nemaline body in congestive cardiomyopathy

Abstract

Transvenous endomyocardial biopsy, first introduced by Konno in 1962, has been an important tool for evaluation of disease of the myocardium, and frequently provides clinically useful information. This study reports a very unusual case of congestive cardiomyopathy in which endomyocardial biopsy tissue showed ultrastructural changes resembling those of nemaline body skeletal myopathy (2).A 60 year old man was admitted to the hospital with progressive dyspnea. He had a history of labile hypertension but was otherwise in generally good health. After admission, acute pulmonary edema developed after several days of progressive paroxymal nocturnal dyspnea. A congestive cardiomyopathy was diagnosed, as well as mild coronary artery disease. The ventricular ejection fraction was 20-30% by both echocardiogram and cardiac catheterization. There was also complex ventricular ectopy including nonsustained ventricular tachycardia. An endomyocardial biopsy was performed during transvenous catheterization.