Left ventricular apical rupture caused by takotsubo cardiomyopathy--comprehensive pathological heart investigation
| Autor: | Jerzy Sacha, Andrzej Wester, Jacek Maselko, Zbigniew Szudrowicz, Władysław Pluta |
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| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
Contraction (grammar) Heart Ventricles Cardiomyopathy Hemorrhage Functional disorder Electrocardiography Takotsubo Cardiomyopathy Internal medicine medicine Humans Lymphocytes Pathological Blood Coagulation Aged 80 and over Cardiotoxicity medicine.diagnostic_test Rupture Spontaneous business.industry Myocardium Cardiac Rupture Contraction band necrosis General Medicine medicine.disease Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Circulation journal : official journal of the Japanese Circulation Society. 71(6) |
| ISSN: | 1346-9843 |
| Popis: | An 81-year-old woman with emotionally-induced takotsubo cardiomyopathy developed a fatal left ventricular (LV) apical rupture. During the hospitalization persistent ST-segment elevation with no electrocardiographic time evolution was observed on the ECG, characteristic for takotsubo cardiomyopathy. Histopathologically, transmural myocardial necrosis with hemorrhage was found at the rupture site, but there were foci of coagulation and contraction band necrosis with mononuclear lymphocyte infiltrations in other heart regions, and the intensity and distribution of these pathological changes corresponded to the distribution of the LV contraction abnormalities seen on ventriculography. The article concludes that: the LV functional disorder in takotsubo cardiomyopathy may be caused by distracted foci of coagulation and contraction band necrosis in the myocardium; contraction band necrosis (a sign of catecholamine cardiotoxicity) may reflect the sympathetic hyperactivity in this disease; persistent myocardial damage expressed by persistent ST-segment elevation without an electrocardiographic time evolution should be carefully observed with sequential echocardiographic examinations because of the possibility of cardiac rupture. |
| Databáze: | OpenAIRE |
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