Transient Left Ventricular Apical Ballooning Syndrome: The First Series in Taiwanese Patients

Fang, Ching-Chang; Jao, Yeun Tarl Fresner Ng; Yi-Chen,; Yu, Ching-Lung; Chen, Chyi‐Liang; Wang, Shih‐Pu

doi:10.1177/0003319707305463

Cited by 10 publications

(5 citation statements)

References 22 publications

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“…Arrhythmia resulting from QT prolongation is commonly observed in patients with TTS. The prevalence of QT interval prolongation among TTS patients is high, ranging from 50% to 100% according to different case series [40], [41], [42]. QT interval prolongation might precipitate TdP, a polymorphic ventricular tachycardia that might lead to ventricular fibrillation and sudden death.…”

Section: Discussionmentioning

confidence: 99%

Recurrent takotsubo with prolonged QT and torsade de pointes and left ventricular thrombus

Ahmed

Serafi

Sunni

et al. 2017

Journal of the Saudi Heart Association

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Takotsubo cardiomyopathy, also known as "takotsubo syndrome," refers to transient apical ballooning syndrome, stress cardiomyopathy, or broken heart syndrome and is a recently recognized syndrome typically characterized by transient and reversible left ventricular dysfunction that develops in the setting of acute severe emotional or physical stress. Increased catecholamine levels have been proposed to play a central role in the pathogenesis of the disease, although the specific pathophysiology of this condition remains to be fully determined. At present, there have been very few reports of recurrent takotsubo cardiomyopathy. In this case report, we present a patient with multiple recurrences of takotsubo syndrome triggered by severe emotional stress that presented with recurrent loss of consciousness, QT prolongation, and polymorphic ventricular tachycardia () and left ventricular apical thrombus.

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Section: Discussionmentioning

confidence: 99%

Recurrent takotsubo with prolonged QT and torsade de pointes and left ventricular thrombus

Ahmed

Serafi

Sunni

et al. 2017

Journal of the Saudi Heart Association

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“…Apical ballooning is a distinct entity and is usually not observed in acute coronary syndrome [16,26]. Coronary artery spasm and left ventricular outflow obstruction have been observed in a few cases, but reports are inconsistent [30].…”

Section: Discussionmentioning

confidence: 99%

Forme Fruste in Recurring Mid-Ventricular Variant of Takotsubo Cardiomyopathy

et al. 2019

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Patient: Female, 69 Final Diagnosis: Mid ventricular type of Takotsubo cardiomyopathy Symptoms: Chest discomfort Medication: — Clinical Procedure: Angiography • 2D echocardiogram Specialty: Cardiology Objective: Unusual clinical course Background: Takotsubo cardiomyopathy (TC) is characterized as acute left ventricular dysfunction precipitated by intense emotional or physiological stress. The mid-ventricular variant of TC usually has akinesis, with or without ballooning of the mid-ventricular segment, and a hyperdynamic base and apex. Recurrence of the typical and atypical (reversed and mid-ventricular type) forms has been reported in only a very small number of cases. We report a forme fruste presentation of mid-ventricular variant of TC. Case Report: A 69-year-old woman with a prior history of stress-induced cardiomyopathy presented with complaint of moderate intensity, persistent, sub-sternal chest discomfort. She reported that her symptoms were similar to those she had during a previous hospitalization in 2015, and this time cited the death of her mother as an inciting stressor. No significant obstructive flow-limiting coronary artery disease was found on cardiac catheterization. However, the left ventriculogram was suggestive of mid-ventricular pattern of TC. Her first symptomatic episode of apparent TC did not reveal completion of the mid-ventricular pattern of the TC variant. The subsequent episode, during this hospitalization, manifested as a completed version of her initial apparent forme fruste of mid-ventricular variant of TC. Conclusions: TC may present in a myriad of clinical forms that must be considered in the evaluation of patients with suspected acute coronary syndromes or cardiomyopathy. Treatment is mainly supportive, and recurrence rates range from 7.7% to 11.4%. To the best of our knowledge, this forme fruste presentation has not been previously reported in recurrent variants of TC.

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“…since the syndrome is more commonly seen in postmenopausal women, estrogen may play a role. 2,4,5,[15][16][17] other proposed mechanisms are elevated catecholamines that cause cardiotoxicity and coronary artery spasm, which lead to myocardial stunning. 3-5, 15, 17…”

Section: Pathophysiologymentioning

confidence: 99%

“…during stressful situations, the increase in catecholamines may cause lvot obstruction that leads to ischemia, in turn causing regional wall motion abnormalities and release of cardiac enzymes. 17…”

Section: Lvot Obstructionmentioning

confidence: 99%

A Mid-Ventricular Variant of Takotsubo Cardiomyopathy

Velankar¹,

Buergler²

2012

Methodist DeBakey Cardiovascular Journal

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Takotsubo cardiomyopathy (TC) was initially recognized in Japan in 1990. The typical patient is a postmenopausal woman with symptoms that mimic an acute coronary syndrome generally following physical or emotional stress. The EKG will typically have dynamic ST segment changes, while the angiogram will usually show normal coronary arteries. In classic TC, the left ventriculogram typically shows akinesis and ballooning of the apex with a normal or hyperdynamic base. Several variants of TC have been described. In this case report, we describe a midventricular variant of TC in a 64-year-old Hispanic female. The patient had chest pain, shortness of breath, elevated cardiac enzymes, and ST-segment elevations in leads II, aVF, and V5-V6. Coronary angiography revealed normal coronary arteries. Left ventriculogram showed hypokinesis of the midventricular segment and hyperdynamic apical and basal regions. Although the exact mechanism of TC is unknown, several theories include loss of estrogen, catecholamine or neurohumoral stimulation, coronary artery spasm, and left ventricular outflow tract (LVOT) obstruction.

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Transient Left Ventricular Apical Ballooning Syndrome: The First Series in Taiwanese Patients

Cited by 10 publications

References 22 publications

Recurrent takotsubo with prolonged QT and torsade de pointes and left ventricular thrombus

Recurrent takotsubo with prolonged QT and torsade de pointes and left ventricular thrombus

Forme Fruste in Recurring Mid-Ventricular Variant of Takotsubo Cardiomyopathy

A Mid-Ventricular Variant of Takotsubo Cardiomyopathy

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