Takotsubo Cardomyopathy: a Clinical Case Report

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Mon, 2016/05/23 - 20:35
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Laboratorinė medicina. 2016,
t. 18,
Nr. 1,
p. 13 -
22

The aim of the study is to present clinical case report of Takotsubo cardio­myopathy, improve knowledge and diag­nostic capabilities of this syndrome.

Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy is a syndrome generally characterized by transient systolic dystunction of the left ventricle, that mimics myocardial infarc­tion, but in the absence of significant cor­onary artery disease, and is often trig­gered by acute emotional or physical stress. Takotsubo cardiomyopathy is much more common in women than men, where catecholamines and estrogens play an important role in the patho­genesis. Diagnostic and treatment is sup­ported mainly by early and well-timed percutaneous coronary intervention and cardiovascular magnetic resonance im­aging. In addition to accurate visualiza­tion of regional wall motion abnormalities, cardiovascular magnetic resonance imaging allows for precise quantification of right ventricular and left ventricular function and the assessment of addi­tional abnormalities, such as pericardial or pleural effusion, thrombi in the heart chambers. Takotsubo cardiomyopathy is accurately identified by cardiovascular magnetic resonance imaging using spe­cific diagnostic criteria: a typical pattern of left ventricular dysfunction, myocar­dial edema, markers for myocardial in­flammation and absence of significant necrosis or fibrosis. Recently, positron emission tomography is described as an alternative way to diagnose Takotsubo cardiomyopathy. Patients undergoing myocardial positron emission tomogra­phy have identified a discrepancy be­tween normal perfusion and reduced glu­cose utilization in dysfunction regions, known as an inverse flow metabolism mismatch and represents a transient metabolic disorder in the cellular level. Nevertheless, prognosis is good, with full recovery of cardiac function within 2-4 weeks in most of the cases. This article describes a clinical case of a 58 years old woman with typical Takotsubo cardiomyopathy, that occurred after sudden emotional stress.

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