scholarly journals What becomes of the broken-hearted? A typical case of Takotsubo cardiomyopathy

2008 ◽  
Vol 7 (3) ◽  
pp. 131-133
Author(s):  
Sreenivasan Shiva ◽  
◽  
Louise M Beckham ◽  
Geoff Dalton ◽  
◽  
...  
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Typical Case ◽  
Cardiac Biomarkers ◽  
Apical Ballooning Syndrome ◽  
St Segment Elevation ◽  
Important Differential Diagnosis ◽  
St Segment ◽  
Electrocardiogram Ecg

Takotsubo cardiomyopathy (TC), or apical ballooning syndrome (ABS), is becoming an increasingly recognised entity. Usually preceded by emotional stress, it is characterised by chest pain associated with ST-segment elevation on the 12-lead electrocardiogram (ECG), elevated cardiac biomarkers, and reversible left ventricular (LV) apical hypokinesia, making it an important differential diagnosis for ST-segment elevation myocardial infarction (STEMI). We present a typical case of TC initially misdiagnosed and treated as a STEMI, fortunately with no adverse consequences…

scholarly journals Can a pneumothorax break your heart?

2015 ◽  
Vol 24 (1) ◽  
pp. 55-8 ◽  
Author(s):  
Stylianos Mavridis ◽  
Hans-Georg Gnauk ◽  
Silvio Horn ◽  
Peter Adeberg ◽  
Martina Schumacher ◽  
...  
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Ventricular Dysfunction ◽  
Troponin I ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Air Leakage ◽  
St Segment Elevation ◽  
St Segment ◽  
Electrocardiographic Findings ◽  
Significant Coronary Stenosis

Takotsubo cardiomyopathy or apical ballooning is a condition characterized by transitory left ventricular dysfunction, affecting commonly postmenopausal females after foregoing acute emotional or physical stress. We report a case of a 63 year old female presenting with severe dyspnea and right-sided secondary spontaneous pneumothorax, initially treated with tube thoracostomy. Despite the fact that pneumothorax resolved, shortness of breath persisted and due to ST-segment elevation and increased Troponin I levels, she was admitted to cardiac catheterization. A significant coronary stenosis was ruled out and the diagnosis of a Takotsubo cardiomyopathy was established. Electrocardiographic findings were normalized within three days and attributable to prolonged air leakage. A thoracoscopic apex resection followed by a partial parietal pleurectomy was performed. Although Takotsubo cardiomyopathy is a rare syndrome, it should always be considered as a potential cardiac complication of a pneumothorax.

scholarly journals Recurrent Stress-Induced Cardiomyopathy: A Case Report and Review Article

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Suman krishna Kotla ◽  
Cyril Nathaniel
Keyword(s):  
Ventricular Dysfunction ◽  
Clinical Presentation ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Apical Ballooning Syndrome ◽  
Single Episode ◽  
St Segment Elevation ◽  
Cardiac Syndrome ◽  
St Segment ◽  
Insight Into

ABS is a unique acute cardiac syndrome and a recently recognized form of transient left ventricular dysfunction. It mimics ACS in clinical presentation (chest pain and dyspnea) and specific ECHO findings in the absence of significant coronary lesions. This rare entity accounts for 2.2% of ST segment elevation ACS. Pathophysiology mostly correlates to stress-induced catecholamine release. The syndrome is predominant in females, mostly in the postmenopausal age group. It should be initially managed according to the guidelines of ACS. The prognosis for apical ballooning syndrome is generally favorable with inpatient hospital mortality less than 2%. Reports of a single episode of ABS are common in recent medical literature; we report a rare case of recurrence that provides more insight into the nature of this unique syndrome.

scholarly journals Electrocardiographic Findings in Takotsubo Cardiomyopathy: ECG Evolution and Its Difference from the ECG of Acute Coronary Syndrome

2014 ◽  
Vol 8 ◽  
pp. CMC.S14086 ◽  
Author(s):  
June Namgung
Keyword(s):  
Acute Coronary Syndrome ◽  
Takotsubo Cardiomyopathy ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Qtc Interval ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
T Wave ◽  
Wave Inversion ◽  
St Segment

Background Electrocardiogram (ECG) manifestations of takotsubo cardiomyopathy (TC) produce ST-segment elevation or T-wave inversion, mimicking acute coronary syndrome (ACS). We describe the ECG manifestation of TC, including ECG evolution, and its different points from ACS. Methods We studied 37 consecutive patients (age 67 ± 15 years, range 23-89, M:F = 12:25) from March 2004 to November 2012 with a diagnosis of TC who were proven to have apical ballooning on echocardiography or left ventricular angiography and normal coronary artery. We analyzed their standard 12-lead ECGs, including rate, PR interval, QRS duration, corrected QT (QTc) interval, ECG evolutions, and arrhythmia events. Results Two common ECG findings in TC were ST-segment elevation (n = 13, 35%) and T inversion (n = 24, 65%), mostly in the precordial leads. After ST-segment resolution, in a few days (3.5 days), diffuse and often deep T-wave inversion developed. Eight patients (22%) had transient Q-waves lasting a few days in precordial leads. No reciprocal ST-segment depression was noted. T-wave inversion continued for several months. QT prolongation (>440 milliseconds) was observed in 37 patients (97%). There were no significant life-threatening arrhythmias except atrial fibrillation (n = 6, 16%). Conclusion There are distinct differences between the ECGs of TC and ACS. These differences will help to differentiate TC from ACS.

Postoperative takotsubo cardiomyopathy: an illustration of the electrocardiographic features that raise suspicion for takotsubo

2013 ◽  
Vol 7 (3) ◽  
pp. 230-235 ◽  
Author(s):  
Hesham R Omar ◽  
James Fairbairn ◽  
Hany D Abdelmalak ◽  
Maja Delibasic ◽  
Enrico M Camporesi
Keyword(s):  
Myocardial Infarction ◽  
Takotsubo Cardiomyopathy ◽  
Systolic Function ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
St Segment Elevation ◽  
Clinical Disorder ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Takotsubo cardiomyopathy is an increasingly recognized clinical disorder mimicking acute coronary syndrome. It is usually preceded by physical or emotional stress and recovery of the left ventricular systolic function occurs in most cases within 1–4 weeks. Takotsubo cardiomypathy can masquerade as ST-segment elevation myocardial infarction when chest pain, ST-segment elevation, and high cardiac biomarkers coexist. ST-segment elevation is encountered in approximately half of the cases of takotsubo cardiomyopathy and its pattern is indistinguishable at times from ST-segment elevation myocardial infarction. However, several electrocardiographic criteria have been shown to characterize takotsubo cardiomyopathy. Awareness of these electrocardiographic features has several diagnostic and therapeutic implications. Nevertheless, these electrocardiographic criteria alone cannot reliably differentiate between both entities, and the diagnosis of takotsubo cardiomyopathy is only established after coronary angiography confirms the absence of occlusive coronary artery disease and the characteristic apical ballooning is evident on left ventriculogram (in the case of the apical form). Herein, we present a case of postoperative takotsubo cardiomyopathy and discuss the various electrocardiographic features that raise suspicion for this transient cardiac syndrome.

Abstract 4840: Tako-Tsubo Cardiomyopathy without Apical Ballooning - Results of the German Tako-Tsubo Registry

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Anastasios Athanasiadis ◽  
Birke Schneider ◽  
Johannes Schwab ◽  
Uta Gottwald ◽  
Ellen Hoffmann ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Ejection Fraction ◽  
Wall Motion ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
T Wave ◽  
Wave Inversion ◽  
St Segment ◽  
Tako Tsubo Cardiomyopathy

Background : The German tako-tsubo cardiomyopathy (TTC) registry has been initiated to further evaluate this syndrome in a western population. We aimed to assess different patterns of left ventricular involvement in TTC. Methods : Inclusion criteria were: 1) acute chest symptoms, 2) reversible ECG changes (ST-segment elevation±T-wave inversion), 3) reversible left ventricular dysfunction with a wall motion abnormality not corresponding to a single coronary artery territory, 4) no significant coronary artery stenoses. Results : A total of 258 patients (pts) from 33 centers were included with a mean age of 68±12 years. Left ventriculography revealed the typical pattern of apical ballooning in 170 pts (66%) and an atypical mid-ventricular ballooning with normal wall motion of the apical and basal segments in 88 pts (34%). Mean age (68±11 vs 67±13 years) and gender distribution (150 women/20 men vs 80 women/8 men) were similar in both groups. Triggering events were present in 78% of the pts with apical ballooning (35% emotional, 34 physical and 9% combination) and in 75% of the pts with mid-ventricular ballooning (39% emotional, 25% physical and 11% combination). As assessed by left ventriculography, ejection fraction was significantly lower in pts with mid-ventricular ballooning (50±15% vs 45±13%, p=0.006). There was no difference in right ventricular involvement. Creatine kinase and troponin I were comparable in both groups. The ECG on admission showed ST-segment elevation in 87% of pts with apical ballooning and in 78% of pts with mid-ventricular ballooning. T-wave inversion was seen in 70% of the pts irrespective of the TTC variant. A Q-wave was significantly less present in pts with mid-ventricular ballooning (30% vs 16%, p=0.04). The QTc interval during the first 3 days was not different among both groups. Conclusion : A variant form with mid-ventricular ballooning was observed in one third of the pts with TTC. Left ventricular ejection fraction was significantly lower in these pts, although they revealed significantly less Q-waves on the admission ECG. All other parameters were similar and confirm the concept that apical and mid-ventricular ballooning represent two different manifestations of the same syndrome.

scholarly journals Recurrent Takotsubo Cardiomyopathy Related to Recurrent Thyrotoxicosis

2016 ◽  
Vol 43 (2) ◽  
pp. 152-155 ◽  
Author(s):  
Keval Patel ◽  
George T. Griffing ◽  
Paul J. Hauptman ◽  
Joshua M. Stolker
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Takotsubo Cardiomyopathy ◽  
Obstructive Coronary Artery Disease ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Apical Ballooning Syndrome ◽  
Wall Motion Abnormalities ◽  
Artery Disease

Takotsubo cardiomyopathy, or transient left ventricular apical ballooning syndrome, is characterized by acute left ventricular dysfunction caused by transient wall-motion abnormalities of the left ventricular apex and mid ventricle in the absence of obstructive coronary artery disease. Recurrent episodes are rare but have been reported, and several cases of takotsubo cardiomyopathy have been described in the presence of hyperthyroidism. We report the case of a 55-year-old woman who had recurrent takotsubo cardiomyopathy, documented by repeat coronary angiography and evaluations of left ventricular function, in the presence of recurrent hyperthyroidism related to Graves disease. After both episodes, the patient's left ventricular function returned to normal when her thyroid function normalized. These findings suggest a possible role of thyroid-hormone excess in the pathophysiology of some patients who have takotsubo cardiomyopathy.

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