A ‘shark’-masked electrocardiogram: case report of a Tako-Tsubo syndrome
Autor: | Monica Verdoia, Orazio Viola, Pier Luigi Soldà, Federica Marrara |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Phenytoin
medicine.medical_specialty 030204 cardiovascular system & hematology Stress Sepsis 03 medical and health sciences Epilepsy 0302 clinical medicine Internal medicine Case report medicine AcademicSubjects/MED00200 Myocardial infarction cardiovascular diseases business.industry Pyometra medicine.disease Coronary occlusion Concomitant Triangular ST-segment elevation Cardiology Tako Tsubo Presentation (obstetrics) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery medicine.drug |
Zdroj: | European Heart Journal: Case Reports |
ISSN: | 2514-2119 |
Popis: | Background Triangular ST-segment elevation or ‘shark-fin’ sign has been described as a specific indicator of acute coronary occlusion and large myocardial ischaemia, translating into poorer prognosis. However, this electrocardiographic presentation has been reported in rare cases of Tako-Tsubo syndrome and associated with more severe physical stressors and neurological involvement. Case summary We present a rare case of a 51-year-old woman presenting with incoming epileptic attacks and concomitant pyometra. Despite controlling epilepsy with phenytoin and the surgical treatment of the infection, she developed sepsis requiring vasopressors, and thereafter sustained ventricular tachycardia and diffuse ST-segment elevation with the ‘shark-fin’ sign. TTC was confirmed by the documentation of normal coronary arteries and the complete recovery of wall motion abnormalities at discharge. Discussion Heterogeneous presentation and triggering conditions often challenge the diagnosis of Tako-Tsubo syndrome. The acknowledgement of different electrocardiographic and clinical manifestations can ease the diagnosis and the successful management of these patients, whose prognosis can be extremely severe in the acute phase, if unidentified. |
Databáze: | OpenAIRE |
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