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Journal of Thrombosis and Thrombolysis

, Volume 44, Issue 2, pp 234–237 | Cite as

Biventricular thrombosis in biventricular stress(takotsubo)-cardiomyopathy

  • Luisa De Gennaro
  • Massimo Ruggiero
  • Sergio Musci
  • Francesco Tota
  • Domenica De Laura
  • Manuela Resta
  • Nicola Locuratolo
  • Francesco Santoro
  • Natale Daniele BrunettiEmail author
  • Pasquale Caldarola
Article

Abstract

Endo-ventricular thrombosis represents a possible clinical complication of stress(takotsubo)-cardiomyopathy (SC). Depressed ventricular systolic ventricular function, localized left ventricular (LV) dyskinesis, but also an increased pro-thrombotic state induced by catecholamine surge may facilitate the occurrence of endovascular thrombosis in SC. SC, however, may also present as right ventricular (RV) dysfunction or even as biventricular ballooning. Ventricular thrombosis may therefore theoretically occur in either ventricles or both. We report the case of an 88-year old woman, with vascular dementia and depression, admitted for abdominal pain, diarrhea, and rectal bleeding. Unexpectedly, electrocardiogram showed induced QT-prolongation with diffuse negative T-waves, while echocardiogram severe LV dysfunction (ejection fraction 35%), but also RV dysfunction and biventricular thrombosis. The diagnosis was therefore biventricular SC complicated by biventricular thrombosis; LV recovered after 10 days. When SC presents with a biventricular involvement, a careful assessment of either ventricular cavities should be therefore recommended to exclude the presence of (bi)ventricular thrombosis. It remains unresolved whether biventricular SC may represent a condition at higher risk of ventricular thrombosis.

Keywords

Stress cardiomyopathy Biventricular dyskinesis Biventricular thrombosis 

Notes

Compliance with ethical standards

Conflict of interest

Authors have no potential conflict of interest to disclose.

Informed consent

The study is purely observational; a patient’s informed consent was signed.

Supplementary material

Four-chamber view showing apical dyskinesis and left ventricular thrombosis (WMV 56 KB)

Short-axis view showing left ventricular thrombosis (WMV 47 KB)

Sub-costal view showing right ventricular thrombosis (asterisk) and left ventricular thrombosis (arrow) (WMV 50 KB)

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Luisa De Gennaro
    • 1
  • Massimo Ruggiero
    • 1
  • Sergio Musci
    • 1
  • Francesco Tota
    • 1
  • Domenica De Laura
    • 1
  • Manuela Resta
    • 1
  • Nicola Locuratolo
    • 1
  • Francesco Santoro
    • 2
    • 3
  • Natale Daniele Brunetti
    • 2
    Email author
  • Pasquale Caldarola
    • 1
  1. 1.Cardiology DepartementOspedale San PaoloBariItaly
  2. 2.Department of Medical and&Surgical SciencesUniversity of FoggiaFoggiaItaly
  3. 3.Cardiology DepartmentAsklepios Klinik Sankt GeorgHamburgGermany

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