Inverted Tako-Tsubo Cardiomyopathy Associated with Bronchoalveolar Lavage

Ok, Kyeong Sam; Song, Bong Gun; Park, Kyoung Sik; Jung, Hyun Hwan; Jung, Hae-Ok; Park, I. Nae; Yum, Ho-Kee; Cho, Wook-Hyun; Choi, Soon-Kun

doi:10.1016/j.hlc.2011.01.004

Cited by 8 publications

(3 citation statements)

References 7 publications

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“…There are a few reports of takotsubo cardiomyopathy induced by flexible bronchoscopy which may be attributed to over-released catecholamines due to the extreme stress [9][10][11][12]. The manifestation of Takotsubo syndrome could be similar to AMI, and it is characterized by transient left ventricular dysfunction and ballooning of the apical part of the left ventricular with reduced LVEF [13,14].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and prognosis of myocardial infarction in a patient without obstructive coronary artery disease during bronchoscopy: a case study and literature review

Liu

Wang

2020

BMC Cardiovasc Disord

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Background It is increasingly recognized that a significant proportion of patients suffered from acute myocardial infraction (AMI) who did not have obstructive coronary artery disease (≥50% diameter stenosis). The term “MINOCA (myocardial infarction with nonobstructive coronary arteries)” was coined for such entity, however, the exact mechanism of MINOCA is still unclear. Herein, we report a patient with MINOCA during bronchoscopy and further review the recent literature. Case presentation A 65-year-old woman was hospitalized with the main complaint of chest tightness, nausea and vomiting for 30 min during bronchoscopy under local anesthesia. Immediate electrocardiogram (ECG) showed ST-segments elevation in leads V2–6 compared with those at admission, and the further evolvement of leads V2–3 into pathological Q wave. Serum cardiac biomarkers revealed high-sensitive cardiac troponin T (hs-cTnT) levels of 20.12 ng/L and 674.6 ng/L at the peak (normal range 0-14 ng/L). Emergency coronary angiography (CAG) showed only approximate 30% stenosis in the left anterior descending (LAD) ostium and 40% stenosis in the first diagonal branch (D1), with quantitative flow ratio (QFR) value for LAD of 0.96. Moreover, her echocardiographic examination presented new significant abnormal wall motion (anterior ventricular wall) with an estimated left ventricular ejection fraction (LVEF) of 62.1% after the cardiac attack. Thoracic enhanced CT scanning indicated no obvious sign of pulmonary embolism. Therefore, with confirmed AMI and the absence of significant coronary stenosis simultaneously, MINOCA was diagnosed with the prescription of dual-antiplatelet, statins, beta-blocker, angiotensin receptors antagonist, calcium channel blocker and nitrate. This patient had a good prognosis during a follow-up of 14 months. Conclusion In this case, bronchoscopy might have caused extremely tense and anxious which led to a sympathetic hyperfunction and acute coronary thrombosis induced by plaque disruption and coronary artery spasm. QFR value is a feasible technique to evaluate the functional coronary stenosis and assist the diagnose of MINOCA. Also, the diagnosis of MINOCA deems an exploration of underlying causes for proper management and prognostic evaluation.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and prognosis of myocardial infarction in a patient without obstructive coronary artery disease during bronchoscopy: a case study and literature review

Liu

Wang

2020

BMC Cardiovasc Disord

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“…Only a few similar cases have been reported. [9][10][11][12] In this case, takotsubo cardiomyopathy occurred due to physical stress from a bronchoscopic examination. A temporary lack of oxygen in her brain due to cardiogenic shock caused by the takotsubo cardiomyopathy is thought to have caused the seizures.…”

Section: Flexible Bronchoscopy-induced Takotsubo Cardiomyopathy E152mentioning

confidence: 99%

Takotsubo Cardiomyopathy and Subsequent Seizures Induced by Flexible Bronchoscopy

Miyoshi

Takeda

et al. 2015

Respir Care

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Takotsubo cardiomyopathy is a transient left-ventricular dysfunction that typically occurs in elderly women due to emotional or physical stress. An 85-y-old woman underwent flexible bronchoscopy to evaluate her malignant lymphoma. After flexible bronchoscopy, she experienced takotsubo cardiomyopathy diagnosed by left ventriculography and subsequent generalized tonic-clonic seizure diagnosed by electroencephalography. Magnetic resonance imaging of her brain after 1 d showed post-convulsive encephalopathy. We believe that these 2 consecutive incidents were caused by the physical stress of the flexible bronchoscopy.

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“…Hxi7j_o.3L 7144alla 7j-foli£ oji TCO] ly-^jûi JiLji£ioJjL[24] epinephrine ± -f-û^ *. o^ TC44^ catecholamine surg A A S--?-ol*1-atropines}-^^11 ^4-2-S 7144 vfl epinephrineol î;-]-^ •¿If^-AA 4141 4^44 l 4 «a^S^Si-è 7l-^^jo] ^^*) 014Ĵ i4-&fe 714^1 ^4^ o\ 7J7144 ai] fe fäfe ^¿91 'àA^]A 4- §-t2l epinephrine 4141 4fe4 "A TC «¿^S-i-7j*i4o|4 44^0] 7144 ^4^ 4 -fûi^ epinephrine^ 4^4 4141 TC £ 9\n]7\ 01431 ^¿ nephrine "^i^.…”

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Ventricular Fibrillation Soon after Endobronchial Epinephrine Application in a Young Man -A Case Report-

Shin

Kim

et al. 2011

Korean J Crit Care Med

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Ventricular fibrillation and cardiac arrest rarely occur after local application of epinepbrine. Local and superficial application of epinephrine is a common hemostatic method during bronchoscopy, especially after biopsies. Although high plasma levels following endobronchial application of epinephrine have been observed in previous animal studies, there is no report of ventricular fibrillation after a usual dose of endobronchial application of epinephrine during bronchoscopy. We present a case of endobronchial epinephrine-induced ventricular fibrillation and cardiac arrest in a 31-year-old man with no previous history of cardiac disease.

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Inverted Tako-Tsubo Cardiomyopathy Associated with Bronchoalveolar Lavage

Cited by 8 publications

References 7 publications

Diagnosis and prognosis of myocardial infarction in a patient without obstructive coronary artery disease during bronchoscopy: a case study and literature review

Diagnosis and prognosis of myocardial infarction in a patient without obstructive coronary artery disease during bronchoscopy: a case study and literature review

Takotsubo Cardiomyopathy and Subsequent Seizures Induced by Flexible Bronchoscopy

Ventricular Fibrillation Soon after Endobronchial Epinephrine Application in a Young Man -A Case Report-

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