Abstract
Tako-tsubo-like cardiomyopathy (TTC) is much more common than originally thought. The exact pathophysiology of TTC is unclear. The most accepted theory proposes myocardial stunning of neurogenic origin, supported by the frequent antecedent of emotional or physical stress, suggesting a catecholamine-mediated mechanism. We present a patient with this syndrome and bilateral damage of the dorsal medulla oblongata likely affecting both solitary tract nuclei. Our case points to a link between baroreflex failure and TTC, highlighting the important role of sympathetic discharge in the pathophysiology of TTC.
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References
Benarroch EE (2008) The arterial baroreflex: functional organization and involvement in neurologic disease. Neurology 71:1733–1738
Biaggioni I, Whetsell WO, Jobe J, Nadeau JH (1994) Baroreflex failure in a patient with central nervous system lesions involving the nucleus tractus solitarii. Hypertension 23:491–495
Robertson D, Hollister AS, Biaggioni I, Netterville JL, Mosqueda-Garcia R, Robertson RM (1993) The diagnosis and treatment of baroreflex failure. N Engl J Med 329:1449–1455
Vidi V, Rajesh V, Singh PP, Mukherjee JT, Lago RM, Venesy DM, Waxman S, Pyne CT, Piemonte TC, Gossman DE, Nesto RW (2009) Clinical characteristics of tako-tsubo cardiomyopathy. Am J Cardiol 104:578–582
Kurowski V, Kaiser A, von Hof K, Killermann DP, Mayer B, Hartmann F, Schunkert H, Radke PW (2007) Apical and midventricular transient left ventricular dysfunction syndrome (tako-tsubo cardiomyopathy): frequency, mechanisms, and prognosis. Chest 132:809–816
Wittstein IS, Thiemann DR, Lima JA, Baughman KL, Schulman SP, Gerstenblith G, Wu KC, Rade JJ, Bivalacqua TJ, Champion HC (2005) Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med 352:539–548
Lassnig E, Weber T, Auer J, Nomeyer R, Eber B (2009) Pheochromocytoma crisis presenting with shock and tako-tsubo-like cardiomyopathy. Int J Cardiol 134:e138–e140
Ketch T, Biaggioni I, Robertson R, Robertson D (2002) Four faces of baroreflex failure: hypertensive crisis, volatile hypertension, orthostatic tachycardia, and malignant vagotonia. Circulation 105:2518–2523
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Berganzo, K., Ciordia, R., Gómez-Esteban, J.C. et al. Tako-tsubo cardiomyopathy in a patient with bilateral lesions in the dorsal medulla. Clin Auton Res 21, 65–67 (2011). https://doi.org/10.1007/s10286-010-0088-0
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DOI: https://doi.org/10.1007/s10286-010-0088-0