Description of a patient suspected of myocardial infarction with normal coronary artery: A case report of Takotsubo Cardiomyopathy
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Abstract
Takotsubo Cardiomyopathy (TC) is transient systolic dysfunction localized with electrocardiographic (ECG) changes, and it mimics acute coronary syndrome (ACS). Studies have shown that 95% of the patients have changes in ECG. ECG changes in TC syndrome may be similar to MI. ECG changes can be seen in the form of ST-segment elevation or deep T-wave inversion. TC can be considered a special form of ACS. TC is not a benign entity and conduction abnormalities can occur. The acute phase can be predicted based on decreased EF and the incidence of arrhythmia. A different treatment is used in the acute phase of TC, depending on the hemodynamic condition. Our case illustrates the importance of symptoms such as stress and emotions, age and female gender, clinical manifestations, ECG characteristics, and echocardiography. This paper describes a case of TC from a hospital affiliated to Rafsanjan University of Medical Sciences. The case was a 75-year-old woman with no history of cardiovascular diseases, who has been admitted to the hospital with myocardial infarction.
1. Stiermaier T, Eitel C, Denef S, Desch S, Schuler G, Thiele H, et al. Prevalence and clinical significance of life-threatening arrhythmias in Takotsubo cardiomyopathy. Journal of the American College of Cardiology. 2015;65(19):2148-50.
2. Kato K, Lyon AR, Ghadri J-R, Templin C. Takotsubo syndrome: aetiology, presentation and treatment. Heart. 2017;103(18):1461-9.
3. Bayon J, Santás-Älvarez M, Ocaranza-Sánchez R, González-Juanatey C. Assessment with intracoronary pressure and flow guidewire, at baseline and after intracoronary adenosine infusion, in a patient with Takotsubo syndrome. Revista Portuguesa de Cardiologia. 2020.
4. Bridgman PG, Chan CW. The fifth takotsubo variant. Echocardiography. 2017;34(1):122-3.
5. Lyon AR, Bossone E, Schneider B, Sechtem U, Citro R, Underwood SR, et al. Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology. European journal of heart failure. 2016;18(1):8-27.
6. Indolfi C, Spaccarotella C, Yasuda M, De Rosa S. The outlook of prognostic indicators for the Takotsubo syndrome. Elsevier; 2018.
7. Namgung J. Electrocardiographic findings in takotsubo cardiomyopathy: ECG evolution and its difference from the ECG of acute coronary syndrome. Clinical Medicine Insights: Cardiology. 2014;8:CMC. S14086.
8. Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, et al. Clinical features and outcomes of Takotsubo (stress) cardiomyopathy. New England Journal of Medicine. 2015;373(10):929-38.
9. Sharkey SW. Electrocardiogram mimics of acute ST-segment elevation myocardial infarction: insights from cardiac magnetic resonance imaging in patients with tako-tsubo (stress) cardiomyopathy. Journal of electrocardiology. 2008;41(6):621-5.
10. Schneider B, Athanasiadis A, Stöllberger C, Pistner W, Schwab J, Gottwald U, et al. Gender differences in the manifestation of tako-tsubo cardiomyopathy. International journal of cardiology. 2013;166(3):584-8.
11. Kono T, Sabbah HN. Takotsubo cardiomyopathy. Heart failure reviews. 2014;19(5):585-93.
12. Care AC. Sepsis-induced myocardial depression and takotsubo syndrome. 2014.
13. Pergolini A, Zampi G, Casali G, Madeo A, Visconti CL, Cipullo PL, et al. Takotsubo syndrome after mitral valve replacement: case report and brief review of the literature. J Cardiothorac Vasc Anesth. 2015;29(29):431-5.
14. Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, et al. Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Annals of internal medicine. 2004;141(11):858-65.
15. Sharkey SW, Lesser JR, Maron BJ. Takotsubo (stress) cardiomyopathy. Circulation. 2011;124(18):e460-e2.
16. Butman SM. Coughing‐induced stress cardiomyopathy. Catheterization and Cardiovascular Interventions. 2010;76(3):388-90.
17. Ghadri JR, Sarcon A, Diekmann J, Bataiosu DR, Cammann VL, Jurisic S, et al. Happy heart syndrome: role of positive emotional stress in takotsubo syndrome. European heart journal. 2016;37(37):2823-9.
18. Abraham J, Mudd JO, Kapur N, Klein K, Champion HC, Wittstein IS. Stress cardiomyopathy after intravenous administration of catecholamines and beta-receptor agonists. Journal of the American College of Cardiology. 2009;53(15):1320-5.
19. Sharkey SW, Windenburg DC, Lesser JR, Maron MS, Hauser RG, Lesser JN, et al. Natural history and expansive clinical profile of stress (tako-tsubo) cardiomyopathy. Journal of the American College of Cardiology. 2010;55(4):333-41.
20. Palecek T, Kuchynka P, Linhart A. Treatment of Takotsubo cardiomyopathy. Current pharmaceutical design. 2010;16(26):2905-9.
2. Kato K, Lyon AR, Ghadri J-R, Templin C. Takotsubo syndrome: aetiology, presentation and treatment. Heart. 2017;103(18):1461-9.
3. Bayon J, Santás-Älvarez M, Ocaranza-Sánchez R, González-Juanatey C. Assessment with intracoronary pressure and flow guidewire, at baseline and after intracoronary adenosine infusion, in a patient with Takotsubo syndrome. Revista Portuguesa de Cardiologia. 2020.
4. Bridgman PG, Chan CW. The fifth takotsubo variant. Echocardiography. 2017;34(1):122-3.
5. Lyon AR, Bossone E, Schneider B, Sechtem U, Citro R, Underwood SR, et al. Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology. European journal of heart failure. 2016;18(1):8-27.
6. Indolfi C, Spaccarotella C, Yasuda M, De Rosa S. The outlook of prognostic indicators for the Takotsubo syndrome. Elsevier; 2018.
7. Namgung J. Electrocardiographic findings in takotsubo cardiomyopathy: ECG evolution and its difference from the ECG of acute coronary syndrome. Clinical Medicine Insights: Cardiology. 2014;8:CMC. S14086.
8. Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, et al. Clinical features and outcomes of Takotsubo (stress) cardiomyopathy. New England Journal of Medicine. 2015;373(10):929-38.
9. Sharkey SW. Electrocardiogram mimics of acute ST-segment elevation myocardial infarction: insights from cardiac magnetic resonance imaging in patients with tako-tsubo (stress) cardiomyopathy. Journal of electrocardiology. 2008;41(6):621-5.
10. Schneider B, Athanasiadis A, Stöllberger C, Pistner W, Schwab J, Gottwald U, et al. Gender differences in the manifestation of tako-tsubo cardiomyopathy. International journal of cardiology. 2013;166(3):584-8.
11. Kono T, Sabbah HN. Takotsubo cardiomyopathy. Heart failure reviews. 2014;19(5):585-93.
12. Care AC. Sepsis-induced myocardial depression and takotsubo syndrome. 2014.
13. Pergolini A, Zampi G, Casali G, Madeo A, Visconti CL, Cipullo PL, et al. Takotsubo syndrome after mitral valve replacement: case report and brief review of the literature. J Cardiothorac Vasc Anesth. 2015;29(29):431-5.
14. Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, et al. Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Annals of internal medicine. 2004;141(11):858-65.
15. Sharkey SW, Lesser JR, Maron BJ. Takotsubo (stress) cardiomyopathy. Circulation. 2011;124(18):e460-e2.
16. Butman SM. Coughing‐induced stress cardiomyopathy. Catheterization and Cardiovascular Interventions. 2010;76(3):388-90.
17. Ghadri JR, Sarcon A, Diekmann J, Bataiosu DR, Cammann VL, Jurisic S, et al. Happy heart syndrome: role of positive emotional stress in takotsubo syndrome. European heart journal. 2016;37(37):2823-9.
18. Abraham J, Mudd JO, Kapur N, Klein K, Champion HC, Wittstein IS. Stress cardiomyopathy after intravenous administration of catecholamines and beta-receptor agonists. Journal of the American College of Cardiology. 2009;53(15):1320-5.
19. Sharkey SW, Windenburg DC, Lesser JR, Maron MS, Hauser RG, Lesser JN, et al. Natural history and expansive clinical profile of stress (tako-tsubo) cardiomyopathy. Journal of the American College of Cardiology. 2010;55(4):333-41.
20. Palecek T, Kuchynka P, Linhart A. Treatment of Takotsubo cardiomyopathy. Current pharmaceutical design. 2010;16(26):2905-9.
| Files | ||
| Issue | Vol 61 No 5 (2023) | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/acta.v61i5.13487 | |
| Keywords | ||
| Takotsubo cardiomyopathy Acute coronary syndrome Myocardial infarction | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Mohammadi V, Zakeri MA, Zakeri M, Ehsani V. Description of a patient suspected of myocardial infarction with normal coronary artery: A case report of Takotsubo Cardiomyopathy. Acta Med Iran. 2023;61(5):305-310.
