Small-vessel Disease in a Patient with Atrial Flutter: Unveiling a Potential Vascular Mechanism of Tachycardia-induced Cardiomyopathy

TL;DR

This case study explores how small-vessel disease might contribute to heart dysfunction caused by rapid heartbeats.

Contribution

It presents a potential vascular mechanism linking small-vessel disease to tachycardia-induced cardiomyopathy.

Findings

A patient with atrial flutter showed marked arteriolar wall thickening consistent with small-vessel disease.

Small-vessel disease may impair myocardial perfusion during persistent tachycardia.

The dysfunction observed was reversible, suggesting a treatable cause of cardiomyopathy.

Abstract

A 65-year-old man presented with new-onset exertional dyspnea. The predominant abnormality was a marked concentric thickening of the arteriolar walls with strong smooth muscle actin positivity, consistent with small-vessel disease (SVD). This case illustrates a potential mechanism of tachycardia-induced cardiomyopathy (TIC), in which SVD may contribute to impaired myocardial perfusion and reversible left ventricular dysfunction under persistent tachycardia.

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