Very Early Recurrence of Takotsubo Syndrome

Xu, Zesheng; Li, Qiang; Liu, Renguang; Li, Yuhong

doi:10.1111/anec.12073

Cited by 5 publications

(3 citation statements)

References 14 publications

(11 reference statements)

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“…The average recurrence rate is reported as 2% to 4% per year (106). Recurrence as soon as 4 days (107) and as late as 10 years (108) has been described. It is noteworthy that it may recur as a different anatomical variant in the same patient (109).…”

Section: Prevention Of Recurrence and Chronic Treatmentmentioning

confidence: 99%

Stress Cardiomyopathy Diagnosis and Treatment

Chazal

Buono

Keyser-Marcus

et al. 2018

Journal of the American College of Cardiology

409

410

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Section: Prevention Of Recurrence and Chronic Treatmentmentioning

confidence: 99%

Stress Cardiomyopathy Diagnosis and Treatment

Chazal

Buono

Keyser-Marcus

et al. 2018

Journal of the American College of Cardiology

409

410

View full text Add to dashboard Cite

“…Several studies reported an average yearly recurrence rate of TTC ranging from 1.8% to 2.9%, with a span of 25 days up to 10 years after the first event . [1] Xu et al [8] reported a patient with TTC who recurred in only 4 days, so very early recurrence is possible. As indicated by the dynamic changes on ECG, our patient had a very early recurrence.…”

Section: Discussionmentioning

confidence: 99%

Takotsubo cardiomyopathy and giant r wave syndrome mimicking acute myocardial infarction

Wang

Guo

2019

Medicine

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Rationale:The clinical features of Takotsubo cardiomyopathy largely overlap with those of acute myocardial infarction, especially in the presence of ST-segment elevation on the initial electrocardiogram. Giant R wave syndrome has mainly been observed in the hyperacute phase of acute myocardial infarction.Patient concerns:In this study, we report a unique case of Takotsubo cardiomyopathy that caused giant R wave syndrome.Diagnosis:A 71-year-old woman was transferred to hospital with new onset chest pain. An initial electrocardiogram showed ST-segment elevation in the inferior wall and anterior wall leads. Her initial cardiac troponin I levels were elevated. Acute myocardial infarction was suspected and the patient underwent emergent cardiac catheterization. A coronary angiography showed no overt stenosis in the coronary artery. After 2 hours, her chest pain disappeared and an electrocardiogram revealed that the ST segment had decreased markedly. However, on day 3, an electrocardiogram of the V1–V6 leads revealed the formation of giant R wave syndrome: giant R waves merging with the markedly elevated ST segments and the obliteration of S waves. Cardiac echocardiography showed hypokinetic apical mid-segments and hyperkinetic basal segments of the left ventricle, low left ventricular ejection (42%), and enlargement of the left ventricle. On the basis of these findings, the patient was diagnosed with early recurrent Takotsubo cardiomyopathy.Interventions:The patient has been treated by levosimendan and furosemide to improve cardiac function before leaving the hospital. After discharge, she was treated with a beta blocker.Outcomes:The patient was discharged 2 weeks later in stable condition without chest pain. One year later, during her follow-up, a repeat echocardiogram and ECG showed normal findings.Lessons:To the best of our knowledge, this is the first report of giant R wave syndrome on electrocardiogram following Takotsubo cardiomyopathy. Takotsubo cardiomyopathy, especially presenting with giant R wave syndrome on electrocardiogram, remains a challenging condition given its similarity to acute myocardial infarction in its early phase.

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“…Y-Hassan et al in their case report [1] "believe that the acute ischemia caused by SCAD has induced mid-apical TTS," because in their case "the dissected OM artery was at a distance from the border region between the akinetic and hyperkinetic regions" [1]. They may be right that in the authors case SCAD precipitated TTS; however it is conceivable that early in the clinical course of the 54-year-old woman, the hinging point between the well and poorly contracting regions was closer to the OM artery, since it has been reported that regional contraction abnormalities occasionally migrate to various parts of the left ventricle in the course of the same TTS attack [7,8]. Also one could conceive maximal mechanical force being applied in one part of a coronary artery, with SCAD occurring in a different part, more vulnerable, of the same artery.…”

mentioning

confidence: 91%

Spontaneous coronary dissection misdiagnosed as, or triggering, or triggered by, Takotsubo syndrome?

Madias

2017

Cathet Cardio Intervent

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Very Early Recurrence of Takotsubo Syndrome

Cited by 5 publications

References 14 publications

Stress Cardiomyopathy Diagnosis and Treatment

Stress Cardiomyopathy Diagnosis and Treatment

Takotsubo cardiomyopathy and giant r wave syndrome mimicking acute myocardial infarction

Spontaneous coronary dissection misdiagnosed as, or triggering, or triggered by, Takotsubo syndrome?

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