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Takotsubo Cardiomyopathy

2006; Lippincott Williams & Wilkins; Volume: 113; Issue: 19 Linguagem: Inglês

10.1161/circulationaha.105.570234

1524-4539

Dipak Shah, Lissa Sugeng, Sascha N. Goonewardena, Patrick D. Coon, Roberto M. Lang,

Cardiovascular Issues in Pregnancy

HomeCirculationVol. 113, No. 19Takotsubo Cardiomyopathy Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBTakotsubo Cardiomyopathy Dipak P. Shah, MD, Lissa Sugeng, MD, Sascha N. Goonewardena, MD, Patrick Coon, BS, RDCS and Roberto M. Lang, MD Dipak P. ShahDipak P. Shah From the Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Ill. , Lissa SugengLissa Sugeng From the Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Ill. , Sascha N. GoonewardenaSascha N. Goonewardena From the Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Ill. , Patrick CoonPatrick Coon From the Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Ill. and Roberto M. LangRoberto M. Lang From the Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Ill. Originally published16 May 2006https://doi.org/10.1161/CIRCULATIONAHA.105.570234Circulation. 2006;113:e762A 63-year-old woman with hypertension presented with chest pain after an argument with her spouse. On arrival, her ECG disclosed ST-segment elevations in the precordial leads with elevated cardiac enzymes. The patient had a prompt transthoracic echocardiogram (TTE), which demonstrated systolic dysfunction with apical ballooning (arrows in Figure, A). Subsequent contrast enhancement of her TTE displayed a paucity of contrast in the apex, thereby signifying perfusion defects in that region (arrows in Figure, D). The patient then underwent emergent cardiac catheterization, which failed to demonstrate coronary artery disease (left coronary artery shown in Figure, F) but did confirm moderate systolic dysfunction with apical ballooning (Figure, C). The patient was medically managed and discharged in stable condition, with follow-up at 3 weeks demonstrating nearly total recovery of cardiac function; the estimated ejection fraction quantified this recovery by increasing from 42% to 56% (Figure, B). Her repeated contrast TTE showed enhancement of the apex consistent with improved perfusion (arrows in Figure, E). Her clinical presentation is consistent with that of Takotsubo cardiomyopathy (Japanese for octopus catcher), a syndrome associated with elderly women often in emotional distress that is characterized by transient apical regional wall motion abnormalities in the absence of epicardial coronary artery disease. Perfusion deficits seen on these contrast TTE images support the hypothesis that Takotsubo cardiomyopathy may be intimately associated with microvascular dysfunction. Download figureDownload PowerPointA, TTE demonstrating apical ballooning. B, Follow-up TTE portraying recovery of apical function. C, Left ventriculogram confirming moderate systolic dysfunction and apical ballooning. D, Myocardial contrast echocardiogram demonstrating perfusion defects in the apical region. E, Follow-up myocardial contrast echocardiogram delineating recovery and perfusion of the apical region. F, Cardiac catheterization demonstrating no epicardial coronary artery disease of the left coronary artery.DisclosuresNone.FootnotesCorrespondence to Roberto M. Lang, MD, FACC, University of Chicago Medical Center, Section of Cardiology, MC 5084, 5841 S Maryland Ave, Chicago, IL 60637. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Tiritilli A, Tritar A, Rehal K, Iaria P, Benali T, Olezac A, Sayah S, Codjia R, Barhoum P, Viard P and Aouate P (2018) Un cas inhabituel de cardiomyopathie de Takotsubo après implantation de pacemaker, Annales de Cardiologie et d'Angéiologie, 10.1016/j.ancard.2018.09.005, 67:5, (374-380), Online publication date: 1-Nov-2018. Duran-Cambra A, Sutil-Vega M, Fiol M, Núñez-Gil I, Vila M, Sans-Roselló J, Cinca J and Sionis A (2014) Systematic Review of the Electrocardiographic Changes in the Takotsubo Syndrome, Annals of Noninvasive Electrocardiology, 10.1111/anec.12228, 20:1, (1-6), Online publication date: 1-Jan-2015. Castillo Rivera A, Ruiz-Bailén M and Rucabado Aguilar L (2011) Takotsubo cardiomyopathy – a clinical review, Medical Science Monitor, 10.12659/MSM.881800, 17:6, (RA135-RA147), . Shah D and Lang R (2011) Takotsubo Cardiomyopathy Dynamic Echocardiography, 10.1016/B978-1-4377-2262-8.00070-0, (306-308), . Otahbachi M, Cevik C, Bagdure S and Nugent K (2010) Excited Delirium, Restraints, and Unexpected Death, American Journal of Forensic Medicine & Pathology, 10.1097/PAF.0b013e3181d76cdd, 31:2, (107-112), Online publication date: 1-Jun-2010. Abdelmoneim S, Mankad S, Bernier M, Dhoble A, Hagen M, Ness S, Chandrasekaran K, Pellikka P, Oh J and Mulvagh S (2009) Microvascular Function in Takotsubo Cardiomyopathy With Contrast Echocardiography: Prospective Evaluation and Review of Literature, Journal of the American Society of Echocardiography, 10.1016/j.echo.2009.07.012, 22:11, (1249-1255), Online publication date: 1-Nov-2009. Ikeda E, Hisamatsu K, Kijima Y, Mizoguchi H, Urakawa S, Kimura H, Miyaji K, Munemasa M, Fujimoto Y, Matsubara H and Mikouchi H (2009) Morphologically Unique Feature of Recurrent Ampulla (Takotsubo) Cardiomyopathy, Circulation Journal, 10.1253/circj.CJ-07-0976, 73:2, (371-375), . Karavidas A, Arapi S, Fotiadis J, Zacharoulis A and Matsakas E (2008) A variant form of acute reversible cardiomyopathy: a case report, Journal of Medical Case Reports, 10.1186/1752-1947-2-74, 2:1, Online publication date: 1-Dec-2008. Mankad S and Nanda N (2007) Impact of Newer Echocardiographic Modalities in the Elderly, The American Journal of Geriatric Cardiology, 10.1111/j.1076-7460.2007.07639.x, 16:6, (349-354), Online publication date: 1-Nov-2007. May 16, 2006Vol 113, Issue 19 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.105.570234PMID: 16702478 Originally publishedMay 16, 2006 PDF download Advertisement SubjectsEchocardiographyHeart Failure