Stress cardiomyopathy - Takotsubo and File:BloodSupplyCardiacConductionSystem.png: Difference between pages

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{{Case
|Title = Takotsubo
|CasePresentation = Mimicking myocardial infarction by a stress cardiomyopathy


An 81-year-old woman with no cardiac history presented with acute chestpain which radiated to the left arm. The blood pressure was 140/80 mmHg and a heart rate of110/min. Physical examination revealed no abnormalities. The electrocardiogram was compatible with acute anterior myocardial infarction. (A) Immediate coronary angiography showed normal coronary arteries (B and C). A left ventricular (LV) angiogram revealed a Tako-tsubo-like cardiomyopathy, recognized by a hypercontractile base and a bulging out of the LV-apex at systole (D), which normalizes at diastole (E). This typical LV-angiogram resembles a local octopus trap in Japan , where this cardiomyopathy was first described. Although clinical presentation can be quite severe, prognosis is usually good with complete LV recovery. It occurs commonly in post-menopausal woman, usually  provoked after extreme emotional stress. In a second interview, the patient told she had a severe emotional experience at a parking lot that morning, after which she developed chestpain.
|Courtesy = Courtesy of M. Meuwissen, MD, PhD, AMC, The Netherlands
|filepointer1=<flash>file=MM0097.swf|quality=best|align=center|width=300|height=300</flash>
|file_name1=MM0097
|descriptionfile1=Takotsubo_LCA
|filepointer2=<flash>file=MM0098.swf|quality=best|align=center|width=300|height=300</flash>
|file_name2=MM0098
|descriptionfile2=Takotsubo_LVangio
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|file_name3=MM0099
|descriptionfile3=Takotsubo_RCA
|filepointer4=[[Image:MM0100.jpg|300px]]
|file_name4=MM0100
|descriptionfile4=Electrocardiogram (A)
|filepointer5=[[Image:MM0101.jpg|300px]]
|file_name5=MM0101
|descriptionfile5=Electrocardiogram (B)
|filepointer6=[[Image:MM0102.jpg|300px]]
|file_name6=MM0102
|descriptionfile6=Electrocardiogram (C)
|filepointer7=[[Image:MM0103.jpg|300px]]
|file_name7=MM0103
|descriptionfile7=Coronary Arteries (B) and (C)
|filepointer8=[[Image:MM0104.jpg|300px]]
|file_name8=MM0104
|descriptionfile8=Coronary Arteries (D)
|filepointer9=[[Image:MM0105.jpg|300px]]
|file_name9=MM0105
|descriptionfile8=Left Ventricular Angiogram (D) and (E)
}}

Revision as of 13:41, 7 February 2014