Electrocardiography ; Humans ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left

An acute pulmonary embolism (PE) and the apical ballooning syndrome (ABS) are both critical and need proper management during the acute stage. We experienced a case of recurrent severe dyspnea because serious right ventricular dysfunction due to PE and left ventricular dysfunction due to ABS occurred consecutively in the short-term and bedside echocardiography has an important role in management in acute settings.
Dyspnea ; Echocardiography ; Hemorrhage ; Pulmonary Embolism ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left ; Ventricular Dysfunction, Right

Stress cardiomyopathy or Takotsubo cardiomyopathy can mimic acute myocardial infarction and recognition of this disease by emergency physician is important. Cardiomyopathy can be represented as variant type - classic, inverted or reverse, mid ventricular, localized. The left ventricular dysfunction that occurs with stress cardiomyopathy is believed to be secondary to a catecholamine surge brought on by intense psychological or physical stress. Regional differences in adrenergic sensitivity or innervation could explain the different variations in wall motion abnormalities. We report here on a case of inverted type stress cardiomyopathy due to iatrogenic epinephrine injection. We hope to raise awareness of the possible harmful effects of epinephrine on the myocardium even in younger patients. Thus, clinicians should be prepared to suspect, recognize, and manage this disease in patients with acute coronary syndrome like symptoms and be aware of possible iatrogenic triggers.
Acute Coronary Syndrome ; Cardiomyopathies ; Emergencies ; Epinephrine* ; Hope ; Humans ; Myocardial Infarction ; Myocardium ; Takotsubo Cardiomyopathy* ; Ventricular Dysfunction, Left

Takotsubo cardiomyopathy or stress induced cardiomyopathy is characterized by acute transient left ventricular apical ballooning without significant coronary artery disease. The pathophysiology of Takotsubo cardiomyopathy remains unclear, but it has been suggested that the stress related neurohumoral factors, especially catecholamines, play an important role. Recently, several reports have described an inverted Takotsubo cardiomyopathy, which is characterized by the dysfunction of the basal and mid-ventricular segments sparing the apex of the heart. In this report, we present a case of a 50-year-old female with a transient left ventricular dysfunction in an inverted Takotsubo pattern, that later was diagnosed as a malignant pheochromocytoma.
Cardiomyopathies ; Catecholamines ; Coronary Artery Disease ; Female ; Heart ; Humans ; Middle Aged ; Pheochromocytoma ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left

Takotsubo cardiomyopathy is a transient condition characterized by acute left ventricular dysfunction without evidence of significant coronary artery obstruction. Takotsubo cardiomyopathy is not an uncommon complication of subarachnoid hemorrhage or acute cerebral infarction, but acute cerebral infarction is a rare thromboembolic complication in patients with Takotsubo cardiomyopathy. We present a patient with acute cerebral infarction following Takotsubo cardiomyopathy associated with pneumothorax.
Cerebral Infarction ; Coronary Vessels ; Humans ; Pneumothorax ; Subarachnoid Hemorrhage ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left

Stress cardiomyopathy (SCMP) is characterized by a transient left ventricular dysfunction associated with apical ballooning and compensatory hyperkinesias of the basal segments after emotional or physical stress, but inverted or mid-ventricular variants of SCMP have also been described. Although catecholamine excess has been suggested as a possible pathophysiologic mechanism of SCMP, the etiology of SCMP is still unknown. Here, we report a case of inverted type of SCMP with clinical presentation mimicking acute coronary syndromes. The cause or precipitating stressor was unclear initially, but pheochromocytoma has been demonstrated as a cause of SCMP during clinical follow-up at out-patient clinic in the present case. Catecholamine-producing tumors should be included in the evaluation or management of SCMP, even though initial clinical manifestations are not suggestive for pheochromocytoma.
Acute Coronary Syndrome ; Cardiomyopathies ; Follow-Up Studies ; Humans ; Hyperkinesis ; Outpatients ; Pheochromocytoma* ; Takotsubo Cardiomyopathy* ; Ventricular Dysfunction, Left

Stress-induced cardiomyopathy or Takotsubo cardiomyopathy is a recently described clinical entity which is associated with a chest pain occurring during a stress, an abnormal ECG and/or an increase in the troponin blood level and a transient left ventricular dysfunction. Transient left ventricular dysfunction generally involves the midsection and the apex of the heart with an akinesis. We reported a case of a 55-year-old female patient who developed a stress-induced cardiomyopathy after local epinephrine use during ophthalmologic surgery.
Cardiomyopathies ; Chest Pain ; Electrocardiography ; Epinephrine ; Female ; Heart ; Humans ; Middle Aged ; Takotsubo Cardiomyopathy ; Troponin ; Ventricular Dysfunction, Left

Epinephrine is widely used for hemostasis during endoscopic sinus surgery performed under local and general anesthesia. However, topical epinephrine can cause many adverse effects, such as hypertension, ventricular tachycardia, pulmonary edema and cardiac arrest. Takotsubo cardiomyopathy is a newly described clinical entity characterized by transient left ventricular dysfunction and no significant coronary artery stenosis. We experienced a rare case of reversible Takotsubo cardiomyopathy in a 56-year-old male after submucosal epinephrine injection with an appropriate dose during an endoscopic sinus surgery.
Anesthesia, General ; Coronary Stenosis ; Epinephrine ; Heart Arrest ; Hemostasis ; Humans ; Hypertension ; Male ; Pulmonary Edema ; Tachycardia, Ventricular ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left

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.
Aged ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Diabetic Ketoacidosis ; Echocardiography ; Electrocardiography ; Female ; Humans ; Myocardial Infarction ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left ; Ventricular Function, Left

Takotsubo cardiomyopathy is a clinical syndrome characterized by chest pain, transient left ventricular dysfunction, and specific electrocardiographic changes induced by physical or emotional stress. We describe a rare case of this syndrome associated with acute mitral valve bacterial endocarditis in a young female.
Chest Pain ; Electrocardiography ; Endocarditis* ; Endocarditis, Bacterial ; Female* ; Humans ; Mitral Valve ; Stress, Psychological ; Takotsubo Cardiomyopathy* ; Ventricular Dysfunction, Left