Viable but denervated right ventricular myocardium: a case of Eisenmenger reaction.

We report on a 47-year-old woman who experienced an Eisenmenger reaction (mean pulmonary artery pressure: 86 mm Hg) induced by atrial septal defect. Radionuclide myocardial scans with 99mTc-MIBI and 123I-BMIPP showed increased uptake to the right ventricular myocardium, whereas the 123I-MIBG scan disclosed no uptake to the right ventricular myocardium. The scans showed no apparent abnormality in the left ventricular myocardium. These findings suggest that the right ventricular myocardium was viable but denervated due to severe pulmonary hypertension. The mechanism of right ventricular failure may be closely related to sympathetic denervation.