, Volume 16, Issue 2, pp 321-324,
Open Access This content is freely available online to anyone, anywhere at any time.
Date: 22 Jan 2009

Persisting myocardial sympathetic dysfunction in takotsubo cardiomyopathy

This is an excerpt from the content

A 73-year-old woman without a cardiovascular history was admitted with chest discomfort, dizziness, and nausea after an emotional meeting with the staff of a nursing home. She experienced the same complaints some years before when her father died.

On admission the patient was in cardiogenic shock. Auscultation of the heart revealed a grade 3/6 systolic murmur radiating to the left axilla. The electrocardiography (ECG) showed an acute anterior wall infarction (Figure 1). Acute coronary angiography was performed but no significant coronary artery disease was found. Left ventricular (LV) angiography showed severe mitral regurgitation and apical ballooning (Figure 2). An intraventricular gradient of 100 mmHg was measured. Echocardiography showed apical akinesia and basal hyperkinesia resulting in severe mitral regurgitation due to systolic anterior movement of the anterior mitral valve leaflet. Troponin T (1.73 ng/L) and CK-MB (22 μg/L) were slightly increased. Based on these findings, the ...