ABSTRACT
This chapter presents a case study of a 59-year-old African-American clerk, who was born on 12 February 1946, was in his usual state of good health until July 2004 (26 months before death) when he was hospitalized for a non–ST-elevation acute myocardial infarction. Cardiac catheterization in July 2004 showed >75% diameter narrowing of the right, left anterior descending, left circumflex, ramus, and obtuse marginal coronary arteries. The left ventricular ejection fraction was estimated to be 50%. The posterobasal left ventricular wall was hypokinetic. Coronary artery bypass grafting was performed on 27 July 2004, and the postoperative course was uncomplicated. At hospital discharge, the simvastatin was increased to 40 mg daily, and he was started on lisinopril 20 mg daily, and aspirin 81 mg daily. A patient is described in whom fatal myopathy occurred, and its cause appears to be the consequence of simvastatin therapy.
