Transient Left Midventricular Dyskinesia: Clinical Features of a New Variant

Gil, Iván J. Núñez; Garcı́a-Rubira, Juan C.; Méndez, María Luaces; Fernández‐Ortíz, Antonio; Balcones, David Vivas; Ferrer, Juan José González; Miguel, Carlos Macaya

doi:10.1016/s1885-5857(08)60122-x

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…Al día de hoy, se han establecido 5 variaciones de la enfermedad: la forma clásica (80%), medioventricular (15%), reversa o basal (2%-5%), tipo focal (1,5%) y las formas atípicas (incluida la que afecta el ventrículo derecho) [5]. Nuestro caso es una variante de discinesia medioventricular poco frecuente, descrita inicialmente en el año 2007 con reporte de 5 casos [16], que al comprometer la pared media suele presentar ondas T invertidas en el electrocardiograma, que en este caso no se presenta [17].…”

Section: Discussionunclassified

Síndrome de Tako-Tsubo en perioperatorio: Una variante rara. Reporte de caso

Tovar¹,

Tejada²,

Galindo³

et al. 2021

Rev. chil. anest.

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Tako-Tsubo syndrome or stress-induced cardiomyopathy has been described as a transient left ventricular apical dyskinesia with chest pain and STsegment elevation on electrocardiogram in the absence of obstructive lesions in coronary arteriography, most commonly in perimenopausal women. It is a rare pathology, with five reported variations and debated pathophysiological mechanisms. The current most accepted theory is a surge of catecholaminergic discharge, associated with genetic predisposition and an emotional or physical stress factor as trigger. We report a case of a 27-year-old woman with a history of uncontrolled asthma and a brother with early heart disease. She underwent appendectomy under general anesthesia and immediately after extubation, she presented a drop in oxygen saturation, respiratory distress, oppressive chest pain, severe arterial hypotension and acute pulmonary edema, requiring reintubation. ST depression on electrocardiogram, positive troponins, coronary arteriography without obstructive lesions, and mid-ventricular hypokinesia was observed in the complementary cardiac studies. Based in these findings, stress cardiomyopathy was diagnosed. The patient progressed favorably, four months after discharge, the patient remained asymptomatic with no changes in the cardiac studies.

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Section: Discussionunclassified

Síndrome de Tako-Tsubo en perioperatorio: Una variante rara. Reporte de caso

Tovar¹,

Tejada²,

Galindo³

et al. 2021

Rev. chil. anest.

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“…There is nearly complete resolu-tion of the apical akinesis in the majority of patients within a month [1,2]. On the other hand, midventricular ballooning syndrome is characterized by only mid-ventricular akinesis with hypercontractility of the apical and basal segments [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. We experienced a patient who presented with transition of left ventricular wall motion from Tako-tsubo type to mid-ventricular ballooning type, and finally to normal wall motion within a day.…”

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A case of transient mid-ventricular ballooning syndrome with a rapid and uncommon recovery

Shimokawahara

Sonoda

Tanaka

et al. 2009

Journal of Cardiology

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A 60-year-old woman presented with acute pulmonary edema followed by cardiopulmonary arrest due to idiopathic ventricular fibrillation. Owing to immediate cardioversion, her electrocardiogram showed sinus rhythm and echocardiography did not show any wall motion abnormalities. The next day, echocardiographic re-examination was characterized by akinesis of both apical and mid segments of the left ventricle. One hour later, subsequently performed coronary angiography revealed non-occlusive coronary artery disease, but left ventriculography demonstrated only akinesis of mid-ventricular segment with hypercontractile other segments. Further echocardiographic investigation on the following day showed total resolution of left ventricular wall motion abnormalities. The diagnosis of mid-ventricular ballooning syndrome was made according to the findings of left ventriculography. In this case, the time course changes of both patient's pathophysiological condition and echocardiographic wall motion from the onset to recovery are rapid and uncommon.

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