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Arq. bras. cardiol ; 89(4): e79-e83, out. 2007. ilus
Article in Portuguese | LILACS | ID: lil-466707

ABSTRACT

Apresenta-se o caso de uma paciente de 71 anos que preencheu os critérios diagnósticos para cardiomiopatia induzida por estresse que foi desencadeada por intenso estresse emocional após atropelamento por bicicleta. O quadro clínico mimetizou o infarto agudo do miocárdio, manifestando-se com dor precordial, supradesnivelamento do segmento ST, seguido por ondas T profundas e prolongamento do intervalo QT, elevação discreta de enzimas cardíacas e cursando com disfunção sistólica apical do ventrículo esquerdo e hipercinesia das porções basais (conferindo o aspecto de "abaloamento apical"), mas na ausência de obstrução coronariana subepicárdica. A função ventricular normalizou-se após a segunda semana de evolução.


The case presented here is of a 71-yr-old female patient who met the diagnostic criteria for stress-induced cardiomyopathy, which was triggered by intense emotional stress after being hit by a bicycle. The clinical picture mimicked that of an acute myocardial infarction, manifesting as precordial pain, ST-segment depression followed by deep negative T waves and prolonging of the QT interval, slight increase in cardiac enzymes and coursing with transient apical ballooning of the left ventricle and hyperkinesis of the basal walls (conferring the aspect of "apical ballooning"), although in the absence of subepicardial coronary obstruction. Ventricular function normalized after the second week of clinical evolution.


Subject(s)
Aged , Female , Humans , Cardiomyopathies/psychology , Stress, Psychological/psychology , Ventricular Dysfunction, Left/psychology , Acute Coronary Syndrome/psychology , Adrenergic beta-Antagonists/therapeutic use , Angiotensin II Type 1 Receptor Blockers/therapeutic use , Diagnosis, Differential , Losartan/therapeutic use , Metoprolol/therapeutic use , Ventricular Dysfunction, Left/diagnosis , Ventricular Dysfunction, Left/drug therapy
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