A broken heart in a broken car

Schlossbauer, Susanne Anna; Ghadri, Jelena-Rima; Cammann, Victoria L.; Maier, Willibald; Lüscher, Thomas F.; Templin, Christian

doi:10.5603/cj.2016.0034

Cited by 3 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The physical stressors that can induce TCM include acute asthma attack, surgery, chemotherapy, stroke, car accident, suicide attempt, etc. [ 6 , 7 , 10 , 13 ]. Various gastrointestinal symptoms such as acute cholecystitis, vomiting, and diarrhea are considered possible triggers for TCM [ 7 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Takotsubo cardiomyopathy in a patient with ileus: a case report

Guo

Chou

2017

BMC Cardiovasc Disord

View full text Add to dashboard Cite

BackgroundTakotsubo cardiomyopathy (TCM) is a form of stress-induced cardiomyopathy featured by the dilatation of the apex of the left ventricle during systole. Whereas the pathogenesis of this disorder is not well understood, it usually occurs after an emotional or physical stress such as acute asthma, surgery, chemotherapy, and stroke. However, its occurrence in ileus patients is rarely reported. We hereby report probably the first case of TCM after ileus in the literature and discuss its implications.Case presentationAn 85-year-old man was brought to the Emergency Department due to vomiting, abdominal pain, and no stool passages for 2 days. His abdomen was markedly distended, and ileus pattern was observed in the plain film of abdomen. Electrocardiogram showed right axis deviation, poor R-wave progression, and diffuse ST-segment elevation in the anterior leads, and cardiomegaly was observed by roentgenogram. A ventriculography showed an ejection fraction of 33% and confirmed the apical dilation consistent with TCM. He was treated with medication and discharged without remarkable adverse events. A follow-up transthoracic echocardiogram 4 months later showed normalization of his left ventricular systolic functions.ConclusionThe precise mechanisms of the development of TCM are still unknown, but it is widely believed that it is triggered by the catecholamine surge produced in response to stress. This case demonstrated that such a stress can be of various forms, including ileus and other conditions that may lead to severe abdominal pain, and highlight the importance of awareness in diagnosing this rare but potentially lethal condition.

show abstract

Section: Discussionmentioning

confidence: 99%

Takotsubo cardiomyopathy in a patient with ileus: a case report

Guo

Chou

2017

BMC Cardiovasc Disord

View full text Add to dashboard Cite

show abstract

“…TTS was largely unknown outside Japan until the first reports from Europe and the US were published in the late 90 s [4,5]. Since then, TTS has been reported from all continents, in both sexes and in different ethnic groups [6][7][8][9][10][11]. Although TTS was initially considered to be harmless, it is now known that it has a wide range of presentations and outcomes, depending on the triggering factor [12].…”

Section: Introductionmentioning

confidence: 99%

Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes. Methods TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients. Results A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients. Conclusion Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers. Trial Registration URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01947621.

show abstract

“…At one one-year follow-up patient had remained free from cardiovascular symptoms and adverse cardiac events, though there was persistent high-degree AV block. Control echocardiogram demonstrated preserved left ventricular function (EF 60%) without wall motion abnormalities.Despite numerous known triggers [3][4][5], the underlying pathophysiological mechanism of timely stunned myocardium and AV conduction damage remains unclear. Whether AV blocks are the cause or consequence of TTC is still a matter of debate.…”

mentioning

confidence: 99%

“…Despite numerous known triggers [3][4][5], the underlying pathophysiological mechanism of timely stunned myocardium and AV conduction damage remains unclear. Whether AV blocks are the cause or consequence of TTC is still a matter of debate.…”

mentioning

confidence: 99%

First report on biventricular stress cardiomyopathy with concomitant atrio-ventricular high-grade conduction disorder

et al. 2017

View full text Add to dashboard Cite

Stress cardiomyopathy (takotsubo cardiomyopathy [TTC]) is an acute cardiac syndrome mimicking acute coronary syndrome (ACS) characterized by typical systolic dysfunction of left ventricle. Right ventricular involvement has been previously reported and represents an important predictor of adverse clinical outcomes. Biventricular involvement occurs in approximately one third of patients [1]. Atrio-ventricular (AV) block complicating TTC occurs in only 5% of patients [2]. Association of biventricular TTC, complete AV block and cardiogenic shock presenting as ACS is extremely rare and has never been reported to date.This study reports a case of an 82-year-old female known to have diabetes mellitus type II as well as CHILD B hepatic cirrhosis on beta-blocker treatment for oesophagal varices and was admitted to the Emergency Department for typical chest pain at rest and vasovagal syncope. Third degree AV block with high ventricular escape was noted on 12-lead electrocardiogram (Fig. 1A). Laboratory results showed an elevation of high-sensitivity cardiac troponin from 130 ng/L to 450 ng/L as well as N-terminal pro B-type natriuretic paptide (NTproBNP) elevation (3905 ng/L). During admission patient developed severe arterial hypotension, bradycardia, and cardiogenic shock. Urgent coronary angiography for very high-risk non-ST-segment elevation ACS was performed and demonstrated unobstructed coronary arteries. Severe biventricular systolic dysfunction with biventricular apical ballooning was noted on ventriculography ( Fig. 1D; Supplementary Movie 5 -see journal website). However, the patient presented persistent high-degree AV block requiring temporary endovenous pacing and finally implantation of a dual-chamber pacemaker at day 10. The patient was discharged on day 12 on enalapril, sitagliptin/ /metformin and simvastatin. At one one-year follow-up patient had remained free from cardiovascular symptoms and adverse cardiac events, though there was persistent high-degree AV block. Control echocardiogram demonstrated preserved left ventricular function (EF 60%) without wall motion abnormalities.Despite numerous known triggers [3][4][5], the underlying pathophysiological mechanism of timely stunned myocardium and AV conduction damage remains unclear. Whether AV blocks are the cause or consequence of TTC is still a matter of debate. The persistence of AV conduction disorders in the setting of transient left ventricle dysfunction inclines reconsideration clinical cardiology

show abstract

A broken heart in a broken car

Abstract: (Cardiol J 2016; 23, 3: 352-354)

Cited by 3 publications

References 11 publications

Takotsubo cardiomyopathy in a patient with ileus: a case report

Takotsubo cardiomyopathy in a patient with ileus: a case report

Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

First report on biventricular stress cardiomyopathy with concomitant atrio-ventricular high-grade conduction disorder

Contact Info

Product

Resources

About