DOI QR코드

DOI QR Code

Coincident Takotsubo Cardiomyopathy and Coronary Artery Disease

Takotsubo 심근병증과 관상동맥 질환의 동시 발생 1예

  • Yun, Myung Ho (Department of Internal Medicine, Saint Carollo Hospital) ;
  • Choi, Seung (Department of Internal Medicine, Saint Carollo Hospital) ;
  • Park, Jae Young (Department of Internal Medicine, Saint Carollo Hospital) ;
  • Kim, Cheol Hwan (Department of Internal Medicine, Saint Carollo Hospital) ;
  • Beom, Jae Won (Department of Internal Medicine, Saint Carollo Hospital) ;
  • Park, Gun (Department of Internal Medicine, Saint Carollo Hospital) ;
  • Kim, Su Hyun (Department of Internal Medicine, Saint Carollo Hospital)
  • 윤명호 (순천 성가롤로병원 내과) ;
  • 최승 (순천 성가롤로병원 내과) ;
  • 박재영 (순천 성가롤로병원 내과) ;
  • 김철환 (순천 성가롤로병원 내과) ;
  • 범재원 (순천 성가롤로병원 내과) ;
  • 박건 (순천 성가롤로병원 내과) ;
  • 김수현 (순천 성가롤로병원 내과)
  • Published : 2012.12.01

Abstract

Takotsubo cardiomyopathy is characterized clinically by transient left ventricular dysfunction in patients with normal coronary angiography findings. We report a case of Takotsubo cardiomyopathy with significant stenosis on coronary angiography. A 71-year-old woman was admitted to our hospital in a drowsy mental state. She was suspected to have diabetic ketoacidosis, but cardiac enzyme levels and electrocardiogram results were typical of myocardial infarction. Coronary angiography revealed occlusion of the distal right coronary artery. Echocardiography and left ventriculography revealed reduced left ventricular function with apical ballooning. However, coronary artery stenosis did not explain the severe reduction in left ventricular function. After 11 days, her left ventricular function and electrocardiogram results had returned to normal. Therefore, coronary artery disease does not rule out the presence of Takotsubo cardiomyopathy.

저자들은 급성 심근 경색증을 의심할 수 있는 심전도를 보이는 환자에서 이전의 보고들과는 달리 관상동맥 질환과 Takotsubo 심근병증이 동시에 발생한 환자를 경험하였고 이를 치료하였기에 보고하는 바이다.

Keywords

References

  1. Akashi YJ, Nakazawa K, Sakakibara M, Miyake F, Koike H, Sasaka K. The clinical features of takotsubo cardiomyopathy. Q J Med 2003;96:563-573. https://doi.org/10.1093/qjmed/hcg096
  2. Sharkey SW, Lesser JR, Zenovich AG, et al. Acute and reversible cardiomyopathy provoked by stress in women from the United States. Circulation 2005;111:472-479. https://doi.org/10.1161/01.CIR.0000153801.51470.EB
  3. Matsuoka K, Okubo S, Fujii E, et al. Evaluation of the arrhythmogenecity of stress-induced "Takotsubo cardiomyopathy" from the time course of the 12-lead surface electrocardiogram. Am J Cardiol 2003;92:230-233. https://doi.org/10.1016/S0002-9149(03)00547-2
  4. Wittstein IS, Thiemann DR, Lima JA, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med 2005;352:539-548. https://doi.org/10.1056/NEJMoa043046
  5. Tsuchihashi K, Ueshima K, Uchida T, et al. Transient left ventricular apical ballooning without coronary artery stenosis: a novel heart syndrome mimicking acute myocardial infarction: Angina Pectoris-Myocardial Infarction Investigations in Japan. J Am Coll Cardiol 2001;38:11-18. https://doi.org/10.1016/S0735-1097(01)01316-X
  6. Desmet WJ, Adriaenssens BF, Dens JA. Apical ballooning of the left ventricle: first series in white patients. Heart 2003;89:1027-1031. https://doi.org/10.1136/heart.89.9.1027
  7. Seth PS, Aurigemma GP, Krasnow JM, Tighe DA, Untereker WJ, Meyer TE. A syndrome of transient left ventricular apical wall motion abnormality in the absence of coronary disease: a perspective from the United States. Cardiology 2003;100:61-66. https://doi.org/10.1159/000073040
  8. Lau KC, Yiu KK, Lee KL, et al. A case of takotsubo cardiomyopathy: transient left ventricular apical ballooning. Hong Kong Med J 2006;12:388-390.
  9. Nunez-Gil IJ, Garcia-Rubira JC, Fernandez-Ortiz A, et al. Apical ballooning syndrome and previous coronary artery disease: a novel relationship. Int J Cardiol 2008;130:e60-e62. https://doi.org/10.1016/j.ijcard.2007.11.056
  10. Villareal RP, Achari A, Wilansky S, Wilson JM. Anteroapical stunning and left ventricular outflow tract obstruction. Mayo Clin Proc 2001;76:79-83. https://doi.org/10.4065/76.1.79
  11. Ueyama T, Kasamatsu K, Hano T, Yamamoto K, Tsuruo Y, Nishio I. Emotional stress induces transient left ventricular hypocontraction in the rat via activation of cardiac adrenoceptors: a possible animal model of 'tako-tsubo' cardiomyopathy. Circ J 2002;66:712-713. https://doi.org/10.1253/circj.66.712
  12. Akashi YJ, Goldstein DS, Barbaro G, Ueyama T. Takotsubo cardiomyopathy: a new form of acute, reversible heart failure. Circulation 2008;118:2754-2762. https://doi.org/10.1161/CIRCULATIONAHA.108.767012
  13. Elesber AA, Prasad A, Lennon RJ, Wright RS, Lerman A, Rihal CS. Four-year recurrence rate and prognosis of the apical ballooning syndrome. J Am Coll Cardiol 2007;50:488-452.

Cited by

  1. A Case of Persistent Apical Ballooning in a Patient with SLE vol.21, pp.2, 2014, https://doi.org/10.4078/jrd.2014.21.2.91
  2. Biventricular Takotsubo Cardiomyopathy Associated with Epilepsy vol.23, pp.4, 2015, https://doi.org/10.4250/jcu.2015.23.4.262
  3. 범뇌하수체저하증의 호르몬 대체요법 중단 후 발생한 스트레스 심근병증 vol.33, pp.2, 2012, https://doi.org/10.12701/yujm.2016.33.2.125