scholarly journals Takotsubo cardiomyopathy: Report of the first case series in Serbia and review of the literature

2010 ◽  
Vol 63 (1-2) ◽  
pp. 75-81 ◽  
Author(s):  
Biljana Putnikovic ◽  
Vojkan Cvorovic ◽  
Milos Panic ◽  
Predrag Milicevic ◽  
Gordana Vojinovic-Maglic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery ◽  
Acute Heart Failure ◽  
Takotsubo Cardiomyopathy ◽  
Coronary Artery Spasm ◽  
Case Series ◽  
Left Ventricular ◽  
Coronary Microvascular Dysfunction ◽  
Review Of The Literature ◽  
First Case

Introduction. Takotsubo cardiomyopathy is a relatively novel cardiac syndrome that is characterized by transient left ventricular asynergy involving apical and mid-ventricular segments. Epidemiology and pathophisiology. It occurs predominantly in elderly women in the absence of obstructive coronary artery disease and is usually associated with severe emotional or physical stress. This syndrome is manifested with chest pain, electrocardiographic changes that mimic acute myocardial infarction, and minimal myocardial enzy?matic release. Several different mechanisms have been proposed: coronary artery spasm, dynamic left ventricular outflow/intracavitary obstruction, coronary microvascular dysfunction and direct catecholamine-mediated cardiomyocite injury. Therapy and prognosis. Complete recovery usually occurs after dramatic presentation, frequently complicated with acute heart failure. Therapy is empiric and directed towards supportive measures against cardiogenic shock, acute heart failure, dysrhythmias. In-hospital mortality rate is less than 1%, but long-term prognosis is still unknown. In addition to the review of the literature on takotsubo cardiomyopathy, we present the first series of patients with this syndrome detected in Clinical Hospital Center Zemun.

Takotsubo cardiomyopathy associated with dydrogesterone use

2021 ◽  
Vol 14 (11) ◽  
pp. e246553
Author(s):  
Adam Ioannou
Keyword(s):  
Coronary Artery Disease ◽  
Case Report ◽  
Coronary Artery ◽  
Takotsubo Cardiomyopathy ◽  
Premenopausal Woman ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Female Sex Hormones ◽  
First Case ◽  
Artery Disease

Takotsubo cardiomyopathy is characterised by left ventricular apical ballooning, in the absence of coronary artery disease, and classically occurs at times of intense stress. Due to the striking preponderance of Takotsubo cardiomyopathy occurring in postmenopausal women, it has been postulated that female sex hormones may also be implicated in its pathogenesis. This case report describes the first case of Takotsubo cardiomyopathy associated with the initiation of dydrogesterone (a synthetic retroprogesterone) in a premenopausal woman.

scholarly journals Reverse takotsubo cardiomyopathy caused by patent foramen ovale-related cryptogenic stroke: a case report

2020 ◽  
Author(s):  
Hiroya Takafuji ◽  
Junya Arai ◽  
Kuniyasu Saigusa ◽  
Kotaro Obunai
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Acute Heart Failure ◽  
Takotsubo Cardiomyopathy ◽  
Transthoracic Echocardiography ◽  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Left Ventricular ◽  
Heart Team ◽  
Foramen Ovale

Abstract Background Reverse takotsubo cardiomyopathy (rTTC) is recognized as an atypical type of TTC. It has been suggested that neurological events are typical trigger of rTTC, especially in young individuals. Case summary In this case report, we describe a 16-year-girl who presented with neurological deficits due to embolic stroke and acute heart failure. Transthoracic echocardiography on admission revealed a severely reduced left ventricular (LV) function with akinesis of basal to mid LV, but normal contraction in apex. Coronary computed tomography angiography confirmed unobstructed coronary arteries. Two weeks later, her LV wall motion and ejection fraction were completely normalized. Transthoracic echocardiography and transoesophageal echocardiography demonstrated no evidence of intracardiac thrombus but showed a patent foramen ovale (PFO) with large shunt. After thorough work-up and brain–heart team discussion, we concluded that the patient developed rTTC due to cryptogenic stroke related with her PFO. She underwent percutaneous PFO closure for secondary prevention with good clinical course. Discussion Reverse TTC is a rare condition. It should be considered in stroke patients with acute heart failure. Quick diagnosis and management with brain–heart team is crucial for better prognosis.

Coronary artery spasm in a neonate with transposition of great arteries: a rare complication and reason for heart transplant

2017 ◽  
Vol 28 (1) ◽  
pp. 163-167
Author(s):  
Neha Bansal ◽  
Ralph E. Delius ◽  
Sanjeev Aggarwal
Keyword(s):  
Coronary Artery ◽  
Cardiac Transplantation ◽  
Arterial Switch Operation ◽  
Coronary Artery Spasm ◽  
Left Ventricular ◽  
Transposition Of Great Arteries ◽  
Arterial Switch ◽  
Coronary Artery Vasospasm ◽  
First Case ◽  
Switch Operation

AbstractArterial switch operation has become the standard of care for d-transposition of great arteries and has excellent short- and long-term outcomes. We report the case of a newborn with a diagnosis of d-transposition of great arteries with intact ventricular septum and a low-risk coronary artery anatomy who developed coronary artery vasospasm while coming off bypass following arterial switch operation in the operating room. The coronary artery spasm led to severe biventricular dysfunction and need for extracorporeal membranous oxygenation support. Despite extracorporeal membranous oxygenation and inotropic support, there was no improvement in the left ventricular function, and cardiac transplantation was performed after 8 days. The explanted heart showed extensive infarction of both ventricles. Both the coronary ostei were patent with no evidence of thrombus, suggesting coronary artery vasospasm rather than embolus or thrombus formation. This is the first case of coronary artery vasospasm in a neonate with d-transposition of great arteries leading to cardiac transplantation. We speculate that early identification of patients who are at a high risk for coronary vasospasm and prophylactic or timely infusion of papaverine directly into the coronary arteries may be beneficial in this condition.

scholarly journals Dynamic obstruction of the left ventricular outflow tract as a possible complication of takotsubo cardiomyopathy

2021 ◽  
Vol 2 (3) ◽  
pp. 94-105
Author(s):  
E. K. Donets ◽  
A. M. Namitokov ◽  
S. V. Kruchinova ◽  
H. D. Kosmacheva
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Takotsubo Cardiomyopathy ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Mitral Insufficiency ◽  
Benign Condition ◽  
Left Ventricular Outflow

Takotsubo cardiomyopathy is a relatively benign condition characterized by stress-induced hypo- and akinesis of the apical segments of the myocardium against the background of intact function of the basal segments. With the addition of obstruction of the left ventricular outflow tract (LVOT) due to hyperkinesis of the basal segments, the patient’s condition and prognosis significantly worsens. In terms of hemodynamic parameters, this situation is similar to obstruction of LVOT in patients with hypertrophic cardiomyopathy, however, due to its rapid development, it can lead to the formation of acute heart failure against the background of low ejection syndrome and acute mitral insufficiency. This article presents a literature review, information on the epidemiology, pathophysiology and diagnosis of this disease, as well as a clinical case of the development of acute heart failure with obstruction of the left ventricular outflow tract and progression of takotsubo syndrome.

Life-threatening Takotsubo Cardiomyopathy

2011 ◽  
Vol 9 (2) ◽  
pp. 119 ◽  
Author(s):  
Karen Mrejen-Shakin ◽  
Ricardo Lopez ◽  
Mohandas M Shenoy ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Acute Heart Failure ◽  
Takotsubo Cardiomyopathy ◽  
Stress Test ◽  
Systolic Dysfunction ◽  
Apical Ballooning ◽  
Assisted Ventilation ◽  
Two Dimensional ◽  
Life Threatening

Objective:To report a case of seizure-induced takotsubo cardiomyopathy with rare etiology and rarer complications.Methods:A 50-year-old woman had multiple epileptic seizures and later developed acute heart failure complicated by ventricular fibrillation and shock. A two-dimensional echocardiogram revealed apical ballooning of the left ventricle resembling a takotsubo (a Japanese fisherman's pot used to trap octopi). The apex was also hypokinetic.Results:The hemodynamic abnormalities normalized with defibrillation, assisted ventilation, inotropic support, and pressor agents. More importantly, the apical ballooning deformity and systolic dysfunction reversed. The echocardiogram normalized three months later. A nuclear treadmill stress test was negative for ischemia.Conclusions:Apical ballooning of the left ventricle and hypokinesis are typical echocardiographic features in takotsubo cardiomyopathy, a stress-induced heart disease. It may follow severe emotional, physical, and neurologic stressors, in our rare case, grand mal seizures (0.2 % of all takotsubo disease patients). Also rare are life-threatening complications. Based on these observations, in a case with severe stress followed by acute heart failure, takotsubo cardiomyopathy should be a major diagnostic consideration. The dramatic initial triggering event, in our case an epileptic seizure, should not mask the possibility of coexisting takotsubo cardiomyopathy. Awareness of this disease, anticipation of complications, and two-dimensional echocardiography will help channel the management in the right direction.

scholarly journals Right ventricular function and its coupling with the pulmonary circulation in acute heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Barki ◽  
M Losito ◽  
M.M Caracciolo ◽  
F Bandera ◽  
M Rovida ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Acute Phase ◽  
Pulmonary Circulation ◽  
Heart Function ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Response To Treatment ◽  
The Right ◽  
B Lines

Abstract Background The right ventricle (RV) is extremely sensitive to hemodynamic changes and increased impedance. In acute heart failure (AHF), the development of pulmonary venous congestion and the increase of left ventricular (LV) filling pressures favors pulmonary vascular adverse remodeling and ultimately RV dysfunction, leading to the onset of symptoms and to a further decay of cardiac dynamics. Purpose The aim of the study was to evaluate RV morphology and functional dynamics at admission and discharge in patients hospitalized for AHF, analyzing the role and the response to treatment of the RV and its coupling with pulmonary circulation (PC). Methods Eighty-one AHF patients (mean age 75.75±10.6 years, 59% males) were prospectively enrolled within 24–48 hours from admission to the emergency department (ED). In either the acute phase and at pre-discharge all patients underwent M-Mode, 2-Dimensional and Doppler transthoracic echocardiography (TTE), as well as lung ultrasonography (LUS), to detect an increase of extravascular lung water (EVLW) and development of pleural effusion. Laboratory tests were performed in the acute phase and at pre-discharge including the evaluation of NT-proBNP. Results At baseline we observed a high prevalence of RV dysfunction as documented by a reduced RV systolic longitudinal function [mean tricuspid annular plane systolic excursion (TAPSE) at admission of 16.47±3.86 mm with 50% of the patients exhibiting a TAPSE<16mm], a decreased DTI-derived tricuspid lateral annular systolic velocity (50% of the subjects showed a tricuspid s' wave<10 cm/s) and a reduced RV fractional area change (mean FAC at admission of 36.4±14.6%). Furthermore, an increased pulmonary arterial systolic pressure (PASP) and a severe impairment in terms of RV coupling to PC was detected at initial evaluation (mean PASP at admission: 38.8±10.8 mmHg; average TAPSE/PASP at admission: 0.45±0.17 mm/mmHg). At pre-discharge a significant increment of TAPSE (16.47±3.86 mm vs. 17.45±3.88; p=0.05) and a reduction of PASP (38.8±10.8 mmHg vs. 30.5±9.6mmHg, p<0.001) was observed. Furthermore, in the whole population we assisted to a significant improvement in terms of RV function and its coupling with PC as demonstrated by the significant increase of TAPSE/PASP ratio (TAPSE/PASP: 0.45±0.17 mm/mmHg vs 0.62±0.20 mm/mmHg; p<0.001). Patients significantly reduced from admission to discharge the number of B-lines and NT-proBNP (B-lines: 22.2±17.1 vs. 6.5±5 p<0.001; NT-proBNP: 8738±948 ng/l vs 4227±659 ng/l p<0.001) (Figure 1). Nonetheless, no significant changes of left atrial and left ventricular dimensions and function were noted. Conclusions In AHF, development of congestion and EVLW significantly impact on the right heart function. Decongestion therapy is effective for restoring acute reversal of RV dysfunction, but the question remains on how to impact on the biological properties of the RV. Funding Acknowledgement Type of funding source: None

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