scholarly journals Surgical treatment of left ventricular wall rupture, regarded as a consequence of Takotsubo cardiomyopathy

2017 ◽  
Vol 5 ◽  
pp. 2050313X1668921 ◽  
Author(s):  
Taalaibek Kudaiberdiev ◽  
Irina Akhmedova ◽  
Gulzada Imanalieva ◽  
Ildar Abdildaev ◽  
Kilichbek Jooshev ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Emotional Stress ◽  
Coronary Arteries ◽  
Takotsubo Cardiomyopathy ◽  
Laboratory Tests ◽  
Left Ventricular ◽  
Left Ventricular Aneurysm ◽  
Lv Function ◽  
Inferior Myocardial Infarction

Objective: We present the case of possible reverse type of TCM in a female patient presented with progressive left ventricular dysfunction and its rupture in pericardium. Methods: The detailed history, physical examination, laboratory tests, electrocardiography, serial echocardiography, coronary angiography with left ventriculography were performed to diagnose possible Takotsubo cardiomyopathy in 63-year old woman admitted to our center with complaints of dyspnea, lightheadedness, weakness and signs of hypotension and history of inferior myocardial infarction, acute left ventricular aneurysm, and effusive pericarditis and pleuritis, developed after emotional stress 5 months ago. Results: Clinical evaluation revealed unremarkable laboratory tests, normal troponin values, signs of old inferior myocardial infarction on electrocardiogram, and left ventricular (LV) dilatation and dysfunction, akinesia of LV infero-lateral wall with thinning and its rupture and blood shunting in pericardium. Her coronary angiography revealed normal coronary arteries. The diagnosis of pheochromocytoma was excluded. The patient underwent surgery under cardiopulmonary bypass with removal of LV pseudoaneurysm. The patient was discharged from hospital with improvement in NYHA class and LV function. Conclusion: Thus, in female postmenopausal patients presenting with acute myocardial infarction signs complicated by pericarditis, intact coronary arteries and LV dysfunction with emotional stress as triggering factor, reverse type of TCM should be considered and proper management applied to prevent development of life-threatening complications like LV rupture.

scholarly journals Takotsubo cardiomyopathy: case report

2017 ◽  
Vol 95 (7) ◽  
pp. 663-668
Author(s):  
Marina G. Matveeva ◽  
G. E. Gogin ◽  
M. N. Alekhin
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricle ◽  
Coronary Arteries ◽  
Takotsubo Cardiomyopathy ◽  
Left Ventricular ◽  
Classical Type ◽  
Coronary Microvascular Dysfunction ◽  
Apical Ballooning Syndrome ◽  
Coronary Syndrome

This article reports a clinical case of Takotsubo cardiomyopathy manifest clinically, biochemicaly, electrocardiographically, and echocardiographicalyas acute myocardial infarction. The diagnosis was based on finding intact coronary arteries and rapid positive dynamics of instrumental and laboratory data. Takotsubo cardiomyopathy (CMP) (stress-associated CMP, apical ballooning syndrome) is a rare reversible disease developing after acute emotional and physical stress. Its prevalence is estimated at 1-2% of all cases of acute myocardial infarction. It most commonly affects postmenopausal women. The clinical picture is similar to that of acute coronary syndrome with transient hypo- and akinesiaof apical and middle segments of the left ventricle (LV) in combination with hyperkinesia of its basal myocardial segment in the absence of stenosis or a spasm of coronary arteries. The precise pathophysiology of the disease is unknown; several hypotheses are proposed including enhancedsympathoadrenal activity, catecholamine multivesselepicardial coronary artery spasm, coronary microvascular dysfunction, catecholamine cardiotoxicity and catecholamine-mediated myocardial stunning. The Mayo Clinic diagnostic criteria are most widely used in clinical practice: transient hypokinesia, akinesia, or dyskinesia of left ventricular mid-segments with or without apical involvement; regional wall motion abnormalities extending beyond the region of blood supply of a single epicardialartery; a stressful event oftenbut not always present in the medical history in the absence of obstructive coronary disease or angiographic evidence of acute plaque rupture; new electrocardiographic abnormalities (either ST-segment elevation and/or T-wave inversion) or modest elevation in cardiac troponin 1 level; the absence of pheochromocytoma and myocarditis. Takotsubo cardiomyopathyhas been classified into 3 types based on the involvement of the left ventricle: classical type, reverse type and mid-ventricular type; lesions of right ventricle are also described. Specific treatment of the disease is unavailable, and the main purpose of therapy is normalization of LV systolic function. The prognosis of Takotsubo cardiomyopathyis favorable, complete clinical recovery is observed in 95,5% of the cases, the average time of recovery is between 2 and 3 weeks.

scholarly journals Prevalence of Myocardial Infarction with Non-Obstructive Coronary Arteries in Western Nepal

2020 ◽  
Vol 17 (2) ◽  
pp. 39-42
Author(s):  
Ram Chandra Kafle ◽  
Girija Shankar Jha ◽  
Dibya Sharma ◽  
Vijay Madhav Alurkar
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Systemic Hypertension ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
Prior Use

Background and Aims: It is well known that ST segment elevation myocardial infarction results from complete occlusion of a coronary artery supplying that area. However, in up to 15% of patients with clinical diagnosis of myocardial infarction, early angiography reveal either non-obstructive or normal coronary artery. This subgroup of disease, myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA), represent a diagnostic and therapeutic challenge to clinicians. We aimed to determine prevalence and clinical profile of patients with MINOCA in current study. Methods: This is a retrospective, observational study conducted in cardiology department of Manipal Teaching Hospital, Pokhara, Nepal from 6th April 2014 to 5th April 2019. Patients with age ≥18 years and clinically diagnosed acute myocardial infarction who underwent coronary angiography without prior use of thrombolytic agents were selected. Data were analyzed using the software SPSS for windows version 18. Results: A total of 177 patients’ underwent early coronary angiography without prior use of thrombolytic agent. The prevalence of MINOCA was 13.5% (n=24) in our study population. MINOCA patients were younger (p<0.001) compared to non-MINOCA. Smoking, systemic hypertension, access through femoral route and depressed left ventricular ejection fraction were significantly lower in MINOCA patients (p<0.05, for all). Conclusion: The prevalence of MINOCA was high (13.5%) in our study. Prospective studies are needed to conclude its high prevalence and to look for other associated factors and etiology.

Surgical Resection of a Lupus-Related Left Ventricular Aneurysm in a Patient with Normal Coronary Arteries: Case Report

2005 ◽  
Vol 8 (2) ◽  
pp. 75 ◽  
Author(s):  
Louis E. Samuels ◽  
William D. Spangler ◽  
Inder Goel
Keyword(s):  
Surgical Resection ◽  
Coronary Arteries ◽  
Lupus Erythematosus ◽  
Left Ventricular ◽  
Left Ventricular Aneurysm ◽  
Lv Function ◽  
Ventricular Aneurysm ◽  
Shortness Of Breath ◽  
Local Repair ◽  
Normal Coronary Arteries

A 52-year-old woman with systemic lupus erythematosus (SLE) presented with shortness of breath. Echocardiography and cardiac catheterization demonstrated a discrete left ventricular aneurysm (LVA) with normal coronary arteries. Although her heart failure symptomatically improved with medical therapy, she suffered an embolic stroke from a thrombus within the LVA. She was treated with anticoagulation and rehabilitation for 6 weeks. Reevaluation with echocardiography demonstrated persistent depressed LV function and mural thrombus within the LVA. Surgical resection of the LVA was performed with evacuation of the thrombus and local repair of the LV.

scholarly journals An Unusual Case of Multiple Left Ventricular Aneurysms Masquerading as Diverticula in the Setting of Myocardial Infarction

2021 ◽  
Vol 15 ◽  
pp. 117954682110066
Author(s):  
Hussain Alzayer ◽  
Ahmad Alshatti ◽  
Akeel Alali
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Unusual Case ◽  
Cardiac Ct ◽  
Incidental Finding ◽  
Left Ventricular ◽  
The Other ◽  
Normal Coronary Arteries ◽  
Other Hand

The distinction between cardiac aneurysms and diverticula can be very difficult by angiography. Left ventricular (LV) aneurysms usually occur following transmural myocardial infarction. On the other hand, cardiac diverticula are most commonly congenital. They are commonly detected by cardiac CT with a prevalence of 2.2%. Here we present a case of a 60-year-old male with the incidental finding of multiple LV aneurysms masquerading as diverticula in the setting of myocardial infarction with near normal coronary arteries. Moreover, this case highlights the limitation of coronary angiography in the diagnosis of myocardial infarction with no obstructive atherosclerosis (MINOCA).

scholarly journals Myocardial Infarction or Takotsubo Cardiomyopathy? A Case Report of a Rare Clinical Dilemma in the Setting of Atrial Myxoma

2021 ◽  
Author(s):  
Balasubramaniyan Amirtha Ganesh ◽  
Sasinthar Rangasamy ◽  
Arumugam Aashish ◽  
Selvaraj Karthikeyan
Keyword(s):  
Myocardial Infarction ◽  
Takotsubo Cardiomyopathy ◽  
Acute Chest Pain ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Atrial Myxoma ◽  
Lv Function ◽  
St Segment Elevation ◽  
Coronary Embolization ◽  
Clinical Dilemma

Abstract Background Acute myocardial infarction (AMI) secondary to coronary embolization is one of the rare complications of atrial myxoma. Takotsubo cardiomyopathy (TCM), a close mimic of AMI, is extremely rare in the setting of atrial myxoma. We report a patient with atrial myxoma presenting with features leading to a clinical dilemma between these two entities. Case summary  A 60-year-old woman presented with acute chest pain with ST segment elevation. Echocardiogram revealed left ventricular (LV) apical ballooning which is typical of TCM, coexisting with a fragile left atrial mass. Emergency coronary angiogram showed a hazy lesion in the circumflex ostium and an intermediate lesion in ramus without any obstruction. Surgical excision of the tumor was done due to features of recurrent coronary embolism. The histopathology examination confirmed it as a myxoma. Regional wall motion abnormalities reversed within a month and LV function normalized. Cardiac magnetic resonance (CMR) imaging at follow-up suggested myocardial infarction. Discussion TCM can occur very rarely in the setting of atrial myxoma. In a patient with atrial myxoma presenting with features of TCM, differentiating it from coronary embolization is important.

scholarly journals Features of the structural state of the myocardium in patients with myocardial infarction without ST segment elevation depending on the nature of the anatomical lesion of the coronary arteries

2021 ◽  
Vol 25 (4) ◽  
pp. 589-592
Author(s):  
V. Yu. Maslovsky
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Angiography ◽  
Functional State ◽  
Coronary Arteries ◽  
Left Ventricular ◽  
Left Ventricular Myocardium ◽  
St Segment Elevation ◽  
St Segment

Annotation. In Ukraine, one of the most pressing medical and social problems is coronary heart disease, in particular, such a form as myocardial infarction. Also, as in most countries, coronary heart disease plays a leading role in morbidity and mortality. In Ukraine, coronary heart disease accounts for 65% of the mortality from diseases of the circulatory system of the working population and is the main cause of disability. The aim of the work is to determine the features of the structural and functional state of the myocardium in patients with myocardial infarction without ST segment elevation depending on the nature of the anatomical lesion of the coronary arteries. We conducted a comprehensive study of 200 patients with acute myocardial infarction without ST-segment elevation (NSTEMI) aged 38 to 80 years. According to coronary angiography, the degree of damage to the coronary arteries was determined, and according to echocardiography – the structural and functional state of the myocardium. Comparison of percentages between groups was performed by the criterion χ2, absolute values – by Mann-Whitney U test. The structural condition of the left ventricular myocardium in NSTEMI patients deteriorated significantly. The total severity of coronary artery disease, calculated from coronary angiography, was> 3, indicating a more severe anatomical lesion of the coronary arteries in these patients. This pathology was associated primarily with an increase in the incidence of eccentric left ventricular hypertrophy. A similar association has been established with regard to the development of left ventricular diastolic dysfunction.

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