Favourable mid-term clinical and echocardiographical follow-up of patients with transient left ventricular apical ballooning

2008 ◽  
Vol 7 ◽  
pp. 35-35
Author(s):  
I TATJERHERNANZ ◽  
J GONZALEZCOSTELLO ◽  
A TORRENSOSES ◽  
J MARISTANYDAUNERT ◽  
A ARIZASOLE ◽  
...  
Keyword(s):  
Apical Ballooning ◽  
Left Ventricular

scholarly journals Takotsubo cardiomyopathy complicating a twin pregnancy at partum

2019 ◽  
Vol 7 (11) ◽  
pp. 4375
Author(s):  
B.V. Nagabhushana Rao ◽  
A. Rekha ◽  
A. Sankar Narayan ◽  
A. Manjusha
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Twin Pregnancy ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Women Authors ◽  
Ventricular Ejection Fraction ◽  
Menopausal Women ◽  
Post Menopausal

Takotsubo cardiomyopathy is a rare syndrome characterized by acute left ventricular dysfunction with regional left ventricular ballooning, mimicking myocardial infarction. This condition is often described in post-menopausal women. Authors present a case in an elderly primi with twin gestation immediately after Cesarean surgery. We discussed her presentation, investigations, diagnosis, management and outcome. 35 year female, a primi with twin pregnancy developed chest pain and shortness of breath immediately after Cesarean surgery. Her Electrocardiograph was abnormal, and Echocardiogram demonstrated abnormal apical ballooning of the left ventricle and severe dysfunction. Cardiac enzymes were elevated and chest skiagram showed pulmonary edema. She was managed in the intensive care unit with oxygen supplementation, diuretics and inotropes. She made an excellent recovery with normalization of left ventricular ejection fraction within 8 days. During the six months follow up, she was asymptomatic and left ventricular function remained normal.

scholarly journals The electrocardiographic ‘triangular QRS-ST-T waveform’ pattern: a marker of severe haemodynamic compromise in Takotsubo syndrome—a case report

2020 ◽  
Vol 4 (3) ◽  
pp. 1-6
Author(s):  
Tuukka Joki ◽  
Kjell Nikus ◽  
Jari Laukkanen
Keyword(s):  
Systolic Dysfunction ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Lv Function ◽  
Takotsubo Syndrome ◽  
St Elevation ◽  
Electrocardiogram Ecg ◽  
Waveform Pattern ◽  
Lambda Wave

Abstract Background Takotsubo cardiomyopathy is characterized by transient regional systolic dysfunction of the left ventricle, mimicking myocardial infarction. Although systolic left ventricular (LV) function normalizes in most cases, the outcome is not always favourable. Recently, a rare electrocardiogram (ECG) finding, lambda wave ST elevation or ‘triangular QRS-ST-T waveform’, was suggested as a possible marker of poor outcome in Takotsubo patients Case summary After a brief episode of chest pain and shortness of breath, a 67-year-old woman developed cardiogenic shock. Her resting ECG showed widespread ST elevations, which soon evolved into a pattern of triangular QRS-ST-T waveforms in the inferior leads and V3–V6. Emergent coronary angiography was normal. The ejection fraction was 20% with apical ballooning and an LV thrombus. At 1-month follow-up, the patient was asymptomatic and the ECG showed only T-wave inversions. Discussion The triangular QRS-ST-T waveform ECG pattern has recently been introduced as a high-risk marker in the Takotsubo syndrome.

Abstract 1072: Myocardial and Microvascular Stunning in Apical Ballooning Syndrome

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Alberto R De Caterina ◽  
Angelo Porfidia ◽  
Simona Giubilato ◽  
Francesca Marzo ◽  
Maurizio Pieroni ◽  
...  
Keyword(s):  
Perfusion Defect ◽  
Myocardial Dysfunction ◽  
Contrast Echocardiography ◽  
Apical Ballooning ◽  
Microvascular Dysfunction ◽  
Left Ventricular ◽  
Apical Ballooning Syndrome ◽  
Early Results ◽  
Score Index

Apical Ballooning Syndrome (ABS) is characterized by chest pain, ST segment elevation at ECG, normal coronary arteries and transient left ventricular (LV) apical a-dyskinesia that typically recovers within a few weeks. Limited and conflicting data about microvascular flow pattern in ABS exist so far. Eight consecutive patients (all women, 72±14 years) presenting with ABS were evaluated by Myocardial Contrast Echocardiography (MCE) at rest, during adenosine test and at 1 month follow-up. Myocardial dysfunction was assessed by Wall Motion Score Index (WMSI) and endocardial length of contractile dysfunction defect (CDD), while myocardial perfusion by Contrast Score Index (CSI) and endocardial length of perfusion defect (PD). MCE study was performed during the infusion of contrast medium (Sonovue, Bracco) at rest and at peak of 90 seconds-infusion of adenosine (140 μg/Kg/min) to elicit coronary microvascular response. LV perfusion defect was present in apical dysfunctional myocardium in all patients. Compared to resting condition, during adenosine WMSI decreased from 1.90±0.29 to 1.72±0.32 (p<.01) and CDD from 40.3±15.5% to 33.2±15.3% of LV endocardial length (p<.001). Similarly, during adenosine test, CSI decreased from 1.55±0.21 to 1.36±0.16, (p<.01) and PD from 23.8±8.6% to 18.6±6.5% of LV endocardial length (p<.05). At follow-up, both myocardial and microvascular dysfunction reverted to normal. Our early results indicate that ABS is characterized by a condition of regional myocardial and microvascular dysfunction partially reversible during adenosine infusion and entirely reversible at 1-month follow-up. These observations suggest that myocardial stunning associated with microvascular stunning could represent a common pathophysiologic pattern in ABS.

Assessment of Myocardial Viability in Persistent Defects on Thallium-201 SPECT after Reinjection Using Gradient-Echo MRI

1996 ◽  
Vol 35 (05) ◽  
pp. 146-152 ◽  
Author(s):  
A. Kögler ◽  
H.-A. Schmitt ◽  
D. Emrich ◽  
H. Kreuzer ◽  
D. L. Munz ◽  
...  
Keyword(s):  
Wall Thickness ◽  
Myocardial Viability ◽  
Cardiac Cycle ◽  
Single Photon ◽  
Contractile Function ◽  
Left Ventricular ◽  
Wall Thickening ◽  
Gradient Echo ◽  
Systolic Wall Thickening

SummaryThis prospective study assessed myocardial viability in 30 patients with coronary heart disease and persistent defects despite reinjection on TI-201 single-photon computed tomography (SPECT). In each patient, three observers graded TI-201 uptake in 7 left ventricular wall segments. Gradient-echo magnetic resonance imaging in the region of the persistent defect generated 12 to 16 short axis views representing a cardiac cycle. A total of 120 segments were analyzed. Mean end-diastolic wall thickness and systolic wall thickening (± SD) was 11.5 ± 2.7 mm and 5.8 ± 3.9 mm in 48 segments with normal TI-201 uptake, 10.1 ± 3.4 mm and 3.7 ± 3.1 mm in 31 with reversible lesions, 11.3 ± 2.8 mm and 3.3 ± 1.9 mm in 10 with mild persistent defects, 9.2 ± 2.9 mm and 3.2 ±2.2 mm in 15 with moderate persistent defects, 5.8 ± 1.7 mm and 1.3 ± 1.4 mm in 16 with severe persistent defects, respectively. Significant differences in mean end-diastolic wall thickness (p <0.0005) and systolic wall thickening (p <0.005) were found only between segments with severe persistent defects and all other groups, but not among the other groups. On follow-up in 11 patients after revascularization, 6 segments with mild-to-moderate persistent defects showed improvement in mean systolic wall thickening that was not seen in 6 other segments with severe persistent defects. These data indicate that most myocardial segments with mild and moderate persistent TI-201 defects after reinjection still contain viable tissue. Segments with severe persistent defects, however, represent predominantly nonviable myocardium without contractile function.

Beurteilung der Adriamycin-Kardiotoxizität mittels der Äquilibrium-Radionuklid-Ventrikulographie

1987 ◽  
Vol 26 (05) ◽  
pp. 206-211 ◽  
Author(s):  
P. Knesewitsch ◽  
N. H. Göldel ◽  
S. Fritsch ◽  
E. Moser
Keyword(s):  
Left Ventricular ◽  
Peak Filling Rate ◽  
Base System ◽  
Filling Rate ◽  
Time To Peak ◽  
Ejection Rate ◽  
Follow Up Studies ◽  
Pathologic Findings ◽  
Peak Ejection Rate

Results of 606 equilibrium radionuclide ventriculographies (ERNV) performed in 348 non-selected patients receiving Adriamycin (ADM) therapy were stored in a data base system. The aim of the study was to assess the influence of a potential cardiotoxic therapy on left ventricular pump function. Increasing ADM doses yielded a significant (p <0.05) decrease of the resting ejection fraction (R-gEF), the peak ejection rate and the peak filling rate. Enddiastolic and endsystolic volumes increased significantly. Stroke volume, heart rate and time to peak filling rate did not change significantly. 368 follow-up studies were performed in 128 patients: 65/128 patients presented a decrease of R-gEF, but only in 45 of these patients R-gEF values fell into the pathologic range. In 44 of these follow-ups, R-gEF remained unchanged. In 19 patients, a R-gEF increase was observed. At the beginning of ADM therapy 14% of the patients had subnormal R-gEF values. With increasing ADM doses pathologic findings increased to 86% in patients with ADM doses higher than 500 mg/m2.

The Carpentier-Edwards Classic and Physio Mitral Annuloplasty Rings: A Randomized Trial

2006 ◽  
Vol 8 (5) ◽  
pp. 389 ◽  
Author(s):  
Ghada M. M. Shahin ◽  
Geert J. M. G. van der Heijden ◽  
Michiel L. Bots ◽  
Maarten-Jan Cramer ◽  
Wybren Jaarsma ◽  
...  
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Absolute Risk ◽  
Statistical Significance ◽  
Nyha Class ◽  
Left Ventricular ◽  
Mitral Annuloplasty ◽  
Risk Of Death ◽  
Late Failure

<P>Objective: To evaluate clinical and echocardiographic outcomes for the semi-flexible Carpentier-Edwards Physio and the rigid Classic mitral annuloplasty ring. </P><P>Methods: Ninety-six patients were randomized for either a Classic (n = 53) or a Physio (n = 43) ring from October 1995 through July 1997. Mean follow-up was 5.1 years (range .1-6.6). We included standard patient characteristics at baseline and during follow-up. Analyses were adjusted for age and gender, and for factors that differed across groups at baseline. In 2002, echocardiography was performed in 74% of the survivors. </P><P>Results: We found a 16% difference in mortality: 14% in the Physio group (n = 6) and 30% in the Classic group (n = 16) (adjusted P = .41). Life table analysis shows that the absolute risk of death after 30 months is lower in the Physio group. Intra-operative repair failure occurred in 3 patients (6%) of the Classic group, and in 4 (9%) of the Physio group, resulting in mitral valve replacement. Late failure occurred in 1 patient (2%) in the Classic group, and in 4 (9%) in the Physio group. At follow-up, left ventricular function did not differ across groups (ejection fraction 45% and 48% (adjusted P = .65)). The combined NYHA class III-IV had improved for the Classic group in 42% and for the Physio group in 34%. </P><P>Conclusion: Although the 16% difference in mortality did not reach statistical significance, it is considered clinically important. No differences in morbidity, valve function, and left ventricular function were found. Further research to explain the difference in mortality is required.</P>

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