Pseudo-acute myocardial infarction due to transient apical ventricular dysfunction syndrome (Takotsubo syndrome).

Autor: Maciel BA; Academic League in Intensive Medicine of Campina Grande- Faculdade de Ciências Médicas de Campina Grande, Brazil., Cidrão AA, Sousa IB, Ferreira JA, Messias Neto VP
Jazyk: English; Portuguese
Zdroj: Revista Brasileira de terapia intensiva [Rev Bras Ter Intensiva] 2013 Mar; Vol. 25 (1), pp. 63-7.
DOI: 10.1590/s0103-507x2013000100012
Abstrakt: Takotsubo syndrome is characterized by predominantly medial-apical transient left ventricular dysfunction, which is typically triggered by physical or emotional stress. The present article reports the case of a 61-year-old female patient presenting with dizziness, excessive sweating, and sudden state of ill feeling following an episode involving intense emotional stress. The physical examination and electrocardiogram were normal upon admission, but the troponin I and creatine kinase-MB concentrations were increased. Acute myocardial infarction without ST segment elevation was suspected, and coronary angiography was immediately performed, which showed severe diffuse left ventricular hypokinesia, medial-apical systolic ballooning, and a lack of significant coronary injury. The patient was referred to the intensive care unit and was successfully treated with supportive therapy. As this case shows, Takotsubo syndrome might simulate the clinical manifestations of acute myocardial infarction, and coronary angiography is necessary to distinguish between both myocardial infarction and myocardial infarction in the acute stage. The present patient progressed with spontaneous resolution of the ventricular dysfunction without any sequelae.
Databáze: MEDLINE