Intensivmedizin und Notfallmedizin

, Volume 46, Issue 1, pp 30–35 | Cite as

Tako-Tsubo-Kardiomyopathie: Differentialdiagnose des akuten Koronarsyndroms

  • D Semmler
  • R Blank
  • H Auerbach
  • H.-J Rupprecht
Kasuistik
  • 84 Downloads

Zusammenfassung

Wir berichten über eine 71-jährige Patientin, die sich mit retrosternalem Druckgefühl in der Notaufnahme unseres Hauses vorstellte. Aufgrund ähnlicher Symptomatik war am Vortag laborchemisch und elektrokardiographisch ein akutes Koronarsyndrom ausgeschlossen worden. Akute physische oder psychische Stressoren wurden seitens der Patientin verneint. Im EKG zeigten sich neu aufgetretene T-Negativierungen über der Vorderwand, laborchemisch zeigten sich diskret erhöhte Parameter der Myokardnekrose. In der Echokardiographie war eine Akinesie der Herzspitze nachweisbar. Die notfallmäßig durchgeführte Koronarangiographie zeigte bei unauffälligen Koronararterien in der Lävokardiographie ein apikales Ballooning des linken Ventrikels.

Aufgrund des klinisch als akutes Koronarsyndrom imponierenden Bildes, dem Ausschluss einer koronaren Herzerkrankung sowie des typischen apikalen Ballooning gehen wir von einer Tako-Tsubo-Kardiomyopathie aus.

Schlüsselwörter

Tako-Tsubo-Kardiomyopathie   Ausschluss einer koronaren Herzerkrankung   apikales Balloning 

Tako-Tsubo cardiomyopathy: Differential diagnosis of an acute coronary syndrome

Abstract

We report on a 71-year-old female, who was admitted to the emergency department because of acute chest pain. Due to similar symptoms the previous day an acute coronary syndrome had been ruled out non-invasively by ECG and laboratory tests. Acute physical or emotional stressful events were negated by the patient. The ECG showed newly diagnosed inverted T waves in the precordial leads. The lab showed a minimal release of myocardial enzymes and proteins. Echocardiographically apical hypokinesia was observed. Coronary angiography revealed no significant occlusion and showed left ventricular apical ballooning. Due to the symptoms resembling acute myocardial infarction, the absence of obstructive coronary disease and the typical left ventricular apical ballooning we assume that the patient had Tako-Tsubo cardiomyopathy.

Keywords

Tako-Tsubo cardiomyopathy   Absence of coronary disease   Apical ballooning 

Notes

Interessenkonflikt

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Copyright information

© Spinger 2009

Authors and Affiliations

  • D Semmler
    • 1
  • R Blank
  • H Auerbach
  • H.-J Rupprecht
  1. 1.II. Medizinische Klinik, GPR-KlinikumRüsselsheimGermany

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