(Reverse Takotsubo syndrome, a rare form of "Broken Heart" syndrome)

Abstract

Reverzní forma takotsubo syndromu patří mezi méně časté varianty akutního syndromu, charakterizovaného reverzibilní akinezí bazálních segmentů levé komory a hyperkontraktilitou její hrotové části. Následující kazuistika pojednává o pacientce s anamnézou úzkostné poruchy, která byla přijata pro pokračující bolesti na hrudi a známky levostranného srdečního selhání. Provedená vyšetření neprokázala jinou etiologii obtíží než reverzní takotsubo syndrom. Po zvládnutí akutního stavu následovalo rychlé odeznění obtíží a poměrně rychlá reparace myokardiálního postižení.

Tako-tsubo syndrome and atrial fibrillation. New trigger for cardiomyopathy. A clinical case

“…Takotsubo syndrome (TS) is described as a pathology with a good prognosis characterized by the presence of a transient left ventricular wall disease without signifi cant culprit obstructive CAD. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The "golden standard" for a defi nitive diagnosis is invasive coronary angiography and ventriculography, with an integrated multi-imaging approach, such as echocardiography, fi rst--line non-invasive technique, and cardiac magnetic resonance (CMR), in order to discriminate TS from other acute cardiac syndromes with troponin elevation and ventricular disfunction. [16][17][18][19] Important hallmarks of TS are a relatively small increase in T/I troponin, the left ventricle "apical ballooning" (wall motion diskinesis characterized by apical akinesis and basal hyperkinesis) at echocardiography and ventriculography associated with normal epicardial coronary vessels at angiography.…”

Atypical presentation of Takotsubo syndrome early after pacemaker implantation

“…This condition mimics an acute myocardial infarction (AMI) because of the symptoms and the new onset of ST segment elevation and/or negative T waves, but without fi ndings of acute obstructive coronary artery disease at angiography, although these can be present in 10-29% of cases. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The diagnosis is made with invasive coronary angiography and ventriculography, together with transthoracic echocardiography which can show different patterns: typical "apical ballooning" of the left ventricle (LV), characterized by apical akinesis and hyperkinesis of the basal segments, or atypical patterns, including the midventricular, basal, and focal wall motion patterns, all of these with reduced ejection fraction. 20 The exact mechani- sm of TTS is unknown, but it is hypothesized that a sudden massive surge of circulatory catecholamines (adrenaline, noradrenaline) from a physical or emotional stress may play a central role.…”