Síndrome de discinesia apical transitoria sin lesiones coronarias: importancia del gradiente intraventricular

Barriales‐Villa, Roberto; Quesada, Raquel Bilbao; Río, Enrique Iglesias; Meleiro, Nicolás Bayón; González, Ramón Mantilla; Lado, Manuel Penas

doi:10.1016/s0300-8932(04)77066-9

Cited by 28 publications

(5 citation statements)

References 11 publications

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“…Acute dynamic LVOT obstruction elevates left ventricular filling pressure, increasing myocardial oxygen demands, and ultimately leads to ischemia. In some patients, this situation can cause a transient left ventricular apical ballooning [17, 18]. In our case, we did not observe this situation.…”

Section: Discussioncontrasting

confidence: 56%

Hypertrophic Cardiomyopathy Mimicking Acute Anterior Myocardial Infarction Associated with Sudden Cardiac Death

Daralammouri

Garhy

Same

et al. 2012

Case Reports in Medicine

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Hypertrophic cardiomyopathy is the most common genetic disease of the heart. We report a rare case of hypertrophic obstructive cardiomyopathy mimicking an acute anterior myocardial infarction associated with sudden cardiac death. The patient presented with acute ST elevation myocardial infarction and significant elevation of cardiac enzymes. Cardiac catheterization showed some atherosclerotic coronary artery disease, without significant stenosis. Echocardiography showed left ventricular hypertrophy with a left ventricular outflow tract obstruction; the pressure gradient at rest was 20 mmHg and became severe with the Valsalva maneuver (100 mmHg). There was no family history of sudden cardiac death. Six days later, the patient suffered a syncope on his way to magnetic resonance imaging. He was successfully resuscitated by ventricular fibrillation.

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Section: Discussioncontrasting

confidence: 56%

Hypertrophic Cardiomyopathy Mimicking Acute Anterior Myocardial Infarction Associated with Sudden Cardiac Death

Daralammouri

Garhy

Same

et al. 2012

Case Reports in Medicine

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“…Our study illustrates matching results in this context. Similarly, in line with most previous reports, the systolic left ventricular function was reduced, comprising a typical akinetic pattern and hypokinesia of the adjoining segments with markedly increased end-diastolic left ventricular pressure as a reflection of acute heart failure, in the majority of our cases [1,12,26]. Only in one case, we recorded a midventricular TTC manifestation.…”

Section: Discussionsupporting

confidence: 92%

Electrocardiographic and Seasonal Patterns Allow Accurate Differentiation of Tako-Tsubo Cardiomyopathy from Acute Anterior Myocardial Infarction: Results of a Multicenter Study and Systematic Overview of Available Studies

Demir

Catalkaya

2019

Biomolecules

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Background. Though several studies about prevalence, etiology, clinical characteristics, preceding events, clinical management, and outcome of Tako-Tsubo cardiomyopathy (TTC) exist, the current knowledge of TTC remains limited. Objective. In 2006, TTC was classified among the acquired forms of cardiomyopathy. On the basis of pathophysiological implications, we analyzed whether the presence of ST-segment elevation in lead -aVR (i.e., ST-segment depression in aVR) and the simultaneous absence of ST-segment elevation in lead V1 allow a reliable differentiation of TTC from acute anterior ST-segment elevation myocardial infarction (STEMI). A further investigative feature is the seasonal variation of TTC. Since acute cardiovascular events exhibit definite chronobiological patterns, various small studies have tried to evaluate whether this is also the case for TTC. Because results are conflicting, we also conducted a multicenter study and analyzed the findings in context with a systematic overview of available studies. Methods. We compared the ECG patterns of 115 patients with TTC, who were admitted to five large acute cardiac care centers associated with university hospitals in Southwestern Germany between January 2001 and June 2011, with those of 100 patients with acute anterior ST-segment elevation myocardial infarction (STEMI) treated in one of these centers. In addition, we performed a computer-assisted MEDLINE search of the literature from January 2000 to September 2011 and analyzed the chronobiological patterns of available TTC cases, including our TTC cohort. Results. Testing the predefined diagnostic criteria was superior to any other electrocardiographic finding and differentiated TTC from anterior STEMI with a sensitivity of 73%, a specificity of 84%, a positive predictive value of 63%, and a negative predictive value of 89%. Beyond that, the onset of TTC showed a clear variation as a function of season and month. While events occurred most frequently during summer (38.4%, p < 0.01), the event rate was the lowest in autumn (16.4%) and winter (21.9%). Chronobiological analyses on a monthly basis identified a significant annual rhythmic pattern in TTC, which peaked in August (11.9%; p < 0.01) and had its nadir in November (6.3%). Conclusions. Our data illustrate that the ST-segment changes in leads aVR and V1 represent a simple and accurate ECG criterion to differentiate TTC from anterior STEMI in patients who are admitted within 12 h of symptom onset. Similarly, the results of our seasonal analysis indicate a distinct chronobiological variation in TTC occurrence. TTC, thereby, differs from major acute cardiovascular diseases, especially acute myocardial infarction (AMI), which is characterized by winter peaks and troughs in summer. If these results are confirmed in large independent cohorts, they may yield diagnostic implications, changing the regular invasive AMI management in TTC patients.

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“…In TCM, there is an expanded reversible myocardial stunning [ 9 , 16 , 17 ], whose origin has not been fully elucidated. Frequently described triggers include sudden strong emotional or physical stress, as for instance exhibited during a car crash, unexpected reunion, death or loss of a close relative or friend, armed robbery, fear of medical interventions, public speaking and appearance before court [ 15 , 18 - 20 ].…”

Section: Aetiology and Pathogenesismentioning

confidence: 99%

“…The result is higher apical and anterior wall tension. Due to the increased need for oxygen, lower systemic blood pressure and the related reduced coronary perfusion, myocardial ischemia (stunning) can lead to regional disorders of wall motion with corresponding changes in the ST-intervals on the surface ECG [ 9 ]. A counter-argument is the lack of echocardiographic or angiographic documentation of an intraventricular gradient in most patients with TCM.…”

Section: Aetiology and Pathogenesismentioning

confidence: 99%

“…Both, ventriculography and echocardiogram showed an apical ballooning with hypercontraction of the basal segments during the acute phase [ 7 ]. In some cases, a left ventricular gradient with a higher velocity in the basal segments can be measured [ 6 , 9 , 10 ]. Furthermore, not only left ventricular but also biventricular infestation has been reported [ 7 ].…”

Section: Diagnosismentioning

confidence: 99%

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Takotsubo Cardiomyopathy: What we have Learned in the Last 25 Years? (A Comparative Literature Review)

Said

Saygili²,

Rana³

et al. 2016

CCR

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We performed a comparative literature review, to elucidate the major features of the Takotsubo (stress) cardiomyopathy (TCM) collected in last 25 years.TCM is characterized by left- or biventricular apical ballooning with a clinical presentation, electrocardiographic abnormalities, and biomarker profils similar to those seen in acute myocardial infarction. Epidemiological studies have shown that TCM is more common in postmenopausal women; however exact figures are not available. The underlying aetiology is still largely undetermined. Elevated catecholamine levels, lack of estrogen, disturbed myocardial fatty acid metabolism and plaque rupture with spontaneous thrombolysis are potentially discussed mechanisms responsible for inducing a prolonged stunned myocardium. Strong emotional or physical stress is the most frequently described trigger in the literature. Therapy recommendations include appropriate antiplatelet treatment, β-blockers and ACE inhibitors. The abnormal kinetics usually resolve or improve within a month and carry a favorable prognosis in most cases. However, all the suspected complications of an acute myocardial infarction, including cardiogenic shock or lethal arrhythmias, may still occur.

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Síndrome de discinesia apical transitoria sin lesiones coronarias: importancia del gradiente intraventricular

Cited by 28 publications

References 11 publications

Hypertrophic Cardiomyopathy Mimicking Acute Anterior Myocardial Infarction Associated with Sudden Cardiac Death

Hypertrophic Cardiomyopathy Mimicking Acute Anterior Myocardial Infarction Associated with Sudden Cardiac Death

Electrocardiographic and Seasonal Patterns Allow Accurate Differentiation of Tako-Tsubo Cardiomyopathy from Acute Anterior Myocardial Infarction: Results of a Multicenter Study and Systematic Overview of Available Studies

Takotsubo Cardiomyopathy: What we have Learned in the Last 25 Years? (A Comparative Literature Review)

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