Stress cardiomyopathy - Takotsubo: Difference between revisions

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|Title = Takotsubo
|Title = Takotsubo
|CasePresentation = Mimicking myocardial infarction by a stress cardiomyopathy
|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
|Courtesy = Courtesy of M. Meuwissen, MD, PhD, AMC, The Netherlands


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|descriptionfile1=Takotsubo_LCA
|descriptionfile1=Figure A: Electrocardiogram
 
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|descriptionfile2=Movie B: Angiography RCA
 
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|descriptionfile4=Movie D: Left ventricular angiography
 


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|descriptionfile5=Image E: Still frames of left ventricular angiography at end systole and end diastole


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Latest revision as of 09:38, 30 August 2009

Takotsubo
Case description: 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 of: Courtesy of M. Meuwissen, MD, PhD, AMC, The Netherlands
MM0100.jpg <flash>file=MM0099.swf
Figure A: Electrocardiogram Movie B: Angiography RCA
Magnifier.pngenlarge

Ppt logo.pngdownload file to use in your powerpoint presentation

<flash>file=MM0097.swf <flash>file=MM0098.swf
Movie C: Angiography LCA Movie D: Left ventricular angiography
Magnifier.pngenlarge

Ppt logo.pngdownload file to use in your powerpoint presentation

Magnifier.pngenlarge

Ppt logo.pngdownload file to use in your powerpoint presentation

MM0105.jpg
Image E: Still frames of left ventricular angiography at end systole and end diastole