Pseudoinfarto agudo do miocárdio devido à síndrome da disfunção ventricular apical transitória (síndrome de Takotsubo)

Abstract

Takotsubo syndrome is characterized by predominantly medial-apical transient left ventricular dysfunction, which is typically triggered by physical or emotional stress. The present article reports the case of a 61-year-old female patient presenting with dizziness, excessive sweating, and sudden state of ill feeling following an episode involving intense emotional stress. The physical examination and electrocardiogram were normal upon admission, but the troponin I and creatine kinase-MB concentrations were increased. Acute myocardial infarction without ST segment elevation was suspected, and coronary angiography was immediately performed, which showed severe diffuse left ventricular hypokinesia, medial-apical systolic ballooning, and a lack of significant coronary injury. The patient was referred to the intensive care unit and was successfully treated with supportive therapy. As this case shows, Takotsubo syndrome might simulate the clinical manifestations of acute myocardial infarction, and coronary angiography is necessary to distinguish between both myocardial infarction and myocardial infarction in the acute stage. The present patient progressed with spontaneous resolution of the ventricular dysfunction without any sequelae.

Takotsubo Syndrome Secondary to Pulmonary Bronchoscopy

“…Complications of bronchoscopy are uncommon and usually occur in older patients with coexisting coronary artery disease, hypertension or compromised pulmonary function, with most of these events being hypoxaemia, arrythmias, bleeding, pneumothorax and pneumomediastinum [9,10] . A typical case of TS is characterized by anginous precordial pain and electrophysiological anomalies, such as ST segment elevation or T wave inversion, which facilitates underdiagnosis due to low clinical suspicion [3,4]. Imaging studies are essential for establishing a diagnosis of stress cardiomyopathy, especially coronary angiography and myocardial magnetic resonance imaging.…”

Miocardiopatía de Tako-Tsubo presentación atípica

“…4,8,9 Esta situación puede cursar muy raramente con complicaciones como shock cardiogénico y edema pulmonar, se presume que entre el 7 y el 32 % de las mujeres postmenopaúsicas y entre el 6 y el 12 % de los varones que ingresan con sospecha de infarto pueden presentar STK; comienza como un cuadro clínico caracterizado por dolor precordial tipo opresivo presente entre el 66-90 % de los pacientes, que se acompaña de disnea o simplemente puede presentarse como un episodio de sincope. [10][11][12][13] Su diagnóstico se ve caracterizado en el electrocardiograma por elevación del ST-T en precordiales y datos analíticos de infarto como elevación de troponinas y Creatinkinasa, pero sin datos de obstrucción coronaria en la angiografía es decir hay viabilidad de las arterias, acompañada de afectación reversible en la contractilidad en la región antero-apical del ventrículo izquierdo y un balonamiento del ventrículo izquierdo en sístole. Sin duda hasta la realización de una coronariografía con ventriculografía (prueba diagnóstica de elección) se debe de iniciar tratamiento como si se tratase de un Infarto Agudo del Miocardio (IAM) y nunca olvidar descartar la Miocardiopatía inducida por cocaína que no es el caso de la paciente por la edad y no existir antecedentes, pero debe siempre considerarse como un diagnóstico diferencial significativo en pacientes con esta patología.…”

Use of extracorporeal membrane oxygenation for treating acute cardiomyopathy after liver transplantation: a case report

“…More modern approaches have proposed diagnosis by non-invasive methods, incorporating data from ECG, echocardiography and magnetic resonance imaging studies. ( 7 )…”