Cardiomiopatía de Tako-tsubo y síndrome de QT largo congénito / Tako-tsubo cardiomyopathy and congenital long QT syndrome

La miocardiopatía de Tako-tsubo (MT) y síndrome de QT largo congénito (SQTLc) son dos entidades que presentan un retardo de la repolarización cardíaca y su asociación ha sido publicada en reportes de casos. Presentamos el caso de una paciente de 55 años, con antecedentes de SQTLc, que ingresó a nuestro hospital por dolor precordial, luego de un evento estresante, diagnosticándose MT. Evolucionó con prolongación del intervalo QT en el electrocardiograma, persistiendo luego de la externación, sin presentar episodios de arritmias ventriculares ni síncope

Takobsubo cardiomyopathy (TC) and congenital long QT syndrome (LQTS) are two entities that present a delay of cardiac repolarization and their association has been published in case reports. We present the case of a 55-year-old female patient with medical history of congenital LQTS, who was admitted to our hospital due to precordial pain after a stressful event and TC was diagnosed. She evolves with QT interval prolongation on the ECG that remains after the externalization, without presenting any episodes of ventricular arrhythmia or syncope

A cardiomiopatia de Tako-tsubo (CT) e a síndrome do QT longo congênito (SQTLc) são duas entidades que apresentam um atraso da repolarização cardíaca e sua associação foi publicada em relatos de casos. Apresentamos o caso de uma paciente de 55 anos de idade com história médica de SQTLc, admitida em nosso hospital devido a dor precordial após um evento estressante, com diagnóstico de CT. Ela evolui com prolongamento do intervalo QT no ECG que permanece após a externalização, sem apresentar nenhum episódios de arritmias ventriculares ou síncope

Nursing care of a case of cardiogenic shock complicated with Tako-Tsubo cardiomyopathy treated by extracorporeal membrane pulmonary oxygen / 中国实用护理杂志

Objective To introduce the nursing care of a case of Tako-Tsubo cardiomyopathy treated with extracorporeal membrane oxygenation (ECMO) and to improve the understanding of Tako-Tsubo cardiomyopathy and ECMO. Methods ECMO nursing group combined with medical treatment group was established to treat Tako-Tsubo cardiomyopathy patients with ECMO, special nursing, division of labor, close monitoring of vital signs and related indicators of Tako-Tsubo cardiomyopathy, ECMO nursing and prevention of complications. Results ECMO on board for 30 minutes, blood gas analysis was improved, the relative indexes of Tako-Tsubo cardiomyopathy were gradually improved after ECMO, the left ventricular ejection fraction gradually recovered after 2 days, and the wall motion gradually returned to normal. After 3 days, the value of serological biomarkers decreased obviously. After 4 days, ECMO therapy was stopped and ECMO tube was removed. After 5 days, tracheal intubation was removed. The patient was stable in condition and discharged from hospital after 41 days of inpatient treatment. Conclusions A rapid and effective ECMO nursing team is an important guarantee for the successful treatment of patients. Close observation of the condition, good team cooperation and reasonable division of labor can be effective. To improve the prognosis of patients.

Nursing care of a case of cardiogenic shock complicated with Tako-Tsubo cardiomyopathy treated by extracorporeal membrane pulmonary oxygen / 中国实用护理杂志

Objective@#To introduce the nursing care of a case of Tako-Tsubo cardiomyopathy treated with extracorporeal membrane oxygenation (ECMO) and to improve the understanding of Tako-Tsubo cardiomyopathy and ECMO.@*Methods@#ECMO nursing group combined with medical treatment group was established to treat Tako-Tsubo cardiomyopathy patients with ECMO, special nursing, division of labor, close monitoring of vital signs and related indicators of Tako-Tsubo cardiomyopathy, ECMO nursing and prevention of complications.@*Results@#ECMO on board for 30 minutes, blood gas analysis was improved, the relative indexes of Tako-Tsubo cardiomyopathy were gradually improved after ECMO, the left ventricular ejection fraction gradually recovered after 2 days, and the wall motion gradually returned to normal. After 3 days, the value of serological biomarkers decreased obviously. After 4 days, ECMO therapy was stopped and ECMO tube was removed. After 5 days, tracheal intubation was removed. The patient was stable in condition and discharged from hospital after 41 days of inpatient treatment.@*Conclusions@#A rapid and effective ECMO nursing team is an important guarantee for the successful treatment of patients. Close observation of the condition, good team cooperation and reasonable division of labor can be effective. To improve the prognosis of patients.

Miocardiopatía de Tako-tsubo, una entidad no tan benigna: A propósito de un caso

La miocardiopatía de Tako-tsubo se conoce como una entidad benigna y reversible. Su presentación típica se caracteriza por la disfunción sistólica transitoria, apical y una base hipercontráctil del ventrículo izquierdo, en ausencia de oclusión coronaria, frecuentemente ocurre en mujeres mayores después de una situación de estrés. Dado que suele simular un síndrome coronario agudo, el diagnóstico diferencial es esencial para su tratamiento. Últimamente, se dio a conocer que las complicaciones intrahospitalarias graves se encuentran en igual proporción que el síndrome coronario agudo. En este caso, se presenta una mujer de edad avanzada, sintomática por disnea clase funcional IV, supradesnivel del segmento ST en cara anterior, con elevación de troponina, arterias coronarias sin lesiones significativas en la cinecoronariografía y evidencia de imágenes compatibles con miocardiopatía de Tako-tsubo en el ecocardiograma transtorácico, complicado durante su hospitalización con shock cardiogénico y taponamiento cardíaco.

Tako-tsubo cardiomyopathy, a not so benign entity About a case Tako-tsubo cardiomyopathy is known as a benign and reversible entity. Its typical presentation is characterized by transient, apical systolic dysfunction and a hypercontractile base of the left ventricle, in the absence of coronary occlusion, frequently occurring in older women after a stressful situation. Since it usually simulates an acute coronary syndrome, the differential diagnosis is essential for its treatment. Recently, it was reported that serious intrahospital complications are found in the same proportion as acute coronary syndrome. In this case, there is an older woman, symptomatic of dyspnea functional class IV, supra-level of the ST segment on the anterior side, with elevation of troponin, coronary arteries without significant lesions in the coronary angiography and evidence of images compatible with Tako-tsubo cardiomyopathy in the transthoracic echocardiogram, complicated during his hospitalization with cardiogenic shock and cardiac tamponade.

Cardiomiopatia de Tako-tsubo, entidade não tão benigna Sobre um relato clínico A cardiomiopatia de Tako-tsubo é conhecida como uma entidade benigna e reversível. Sua apresentação típica é caracterizada por disfunção sistólica transitória, apical e uma base hipercontrátil do ventrículo esquerdo, na ausência de oclusão coronária, ocorre frequentemente em mulheres mais velhas, após uma situação estressante. Como geralmente simula uma síndrome coronariana aguda, o diagnóstico diferencial é essencial para o tratamento. Recentemente, foi relatado que complicações intra-hospitalares graves são encontradas na mesma proporção que a síndrome coronariana aguda. Neste caso, uma mulher idosa, sintomática por dispneia classe funcional IV, elevação do segmento ST no cara anterior, com elevação da troponina, artérias coronárias sem lesões significativas na angiografia coronária e evidência de imagens compatíveis com cardiomiopatia de Tako-tsubo no ecocardiograma transtorácico, complicado durante sua internação com choque cardiogênico e tamponamento cardíaco.

Síndrome del corazón roto y estrés agudo / A propósito de un caso

Resumen Introducción: El estrés se ha asociado con un síndrome de insuficiencia cardiaca aguda, con morbilidad y mortalidad importantes. Metodología: Reporte de caso y revisión no sistemática de la literatura relevante. Presentación del caso: Mujer de 65 arios con antecedente de trastorno de ansiedad generalizada no tratado que, tras la muerte violenta de un hijo, sufría dolor opresivo en el precordio, el cuello y la extremidad superior izquierda que duraba más de 30 min; la sospecha clínica inicial fue síndrome coronario agudo. Revisión de la literatura: La miocardiopatía de tako-tsubo se caracteriza por disfunción ventricular izquierda, reversible en la mayoría de los casos, y alteraciones del movimiento de la pared ventricular sin anormalidades coronarias, asociado a altas concentraciones plasmáticas de catecolaminas, que en la mayoría de los casos coinciden con un estresor agudo de tipo físico o emocional. Conclusiones: La miocardiopatía de tako-tsubo es un diagnóstico diferencial que los médicos que atienden a pacientes con sospecha de síndrome coronario deben considerar, especialmente ante mujeres posmenopáusicas con antecedentes de comorbilidades psiquiátricas como el trastorno de ansiedad generalizada.

Abstract Introduction: Stress has been associated with an acute heart failure syndrome of important morbidity and mortality. Methods: Case report and non-systematic review of the relevant literature. Case presentation: A 65-year-old woman with a history of an untreated generalized anxiety disorder, whom after the violent death of her son presented with oppressive chest pain irradiated to neck and left superior extremity, lasting for more than 30 minutes, initial clinical suspect suggests acute coronary syndrome. Literature review: Tako-tsubo cardiomyopathy is characterized by a reversible left ventricular dysfunction and wall movement abnormalities, without any compromise of the coronary arteries, associated to high plasma levels of catecholamines which in most cases correlates with an acute stress of emotional or physical type. Conclusions: Tako-tsubo cardiomyopathy has to be considered by physicians among the differential diagnosis when facing patient with suspected acute coronary syndrome, especially in postmenopausal women with a history of psychiatric comorbidities such as a generalized anxiety disorder.

Broken Heart Syndrome– An Intra Operative Complication.

We report a case of Broken heart Syndrome in a 56 year old Postmenopausal women suffered while undergoing simple biopsy procedures for vocal cord polyp that lead to physical, mental and financial burden both for the patient and doctors. The diagnosis of this case is made by a team of cardiologists based on clinical and echocardiographic findings.

Tako-Tsubo Cardiomyopathy Triggered by Misdirection

Tako-Tsubo cardiomyopathy (TTC), also known as transient left ventricular apical ballooning syndrome or stress-induced cardiomyopathy, is a novel reversible cardiomyopathy mimicking acute myocardial infarction without epicardial coronary artery disease. The exact physiopathology of TTC remains unclear. It is usually precipitated by acute physical or emotional stress and it most commonly affects postmenopausal women. The growing number of clinical cases of TTC have demonstrated a wide field of possible etiologies beyond the emotional stress. We report a case of a 67-year-old postmenopausal woman who was being supplemented by enteral feeding via a nasogastric tube and who developed TTC due to misdirection, probably favored by the mechanical blockade by the nasogastric tube, while swallowing the drug pills.

Tako-Tsubo Cardiomyopathy by Transient Dynamic Left Midventricular Obstruction

A 48-year-old woman visited the emergency department with shock due to a urinary tract infection. The patient, who had a history of hypertension and diabetes mellitus, presented with precordial ST-segment elevation and Q waves, along with an increase of cardiac enzymes. An echocardiography showed moderately reduced systolic function, severe apical left ventricular ballooning, and a dynamic left ventricular outflow tract obstruction with a pressure gradient of 109 mmHg. Coronary angiography demonstrated normal coronary arteries. At the 1-month echocardiographic follow-up, the apical ballooning and left ventricular systolic function had recovered completely. There was no residual left ventricular intra-cavity gradient at rest, but it was induced in low-dose dobutamine stress-echocardiography. We demonstrated that dynamic left midventricular obstruction in the setting of either increased catecholamine stress or hypovolemia could develop Tako-tsubo cardiomyopathy.

Magnetic Resonance Imaging of Transient Left Ventricular Apical Ballooning Related to Emotional Stress: a Case Report

Transient left ventricular apical ballooning is characterized by transient wall motion abnormalities involving the left ventricular apex and mid-ventricle in the absence of coronary arterial occlusion. A 66-year-old woman presented to the emergency department with chest pain that mimicked acute myocardial infarction. An aortogram showed akinesis from the mid to apical left ventricle with sparing of the basal segments. Four days later, she underwent MRI, which demonstrated characteristic apical contractile dysfunction, the same as the aortogram, without evidence of myocardial infarction on the MRI. Two weeks later, her symptoms were resolved and follow-up echocardiography showed normal ventricular function.