A case of stress-induced cardiomyopathy with an "inverted Takotsubo" contractile pattern / 대한내과학회지

Stress-induced cardiomyopathy, known as Takotsubo cardiomyopathy, is a newly described clinical entity characterized by transient left ventricular apical ballooning and left ventricular apical dyskinesis, with no significant stenosis on the coronary angiogram. We describe a patient who had transient cardiomyopathy with akinesia of the basal portions of the left ventricle and hyperkinesia of the apex. This is the first case of stress-induced cardiomyopathy with an "inverted Takotsubo" contractile pattern triggered by emotional stress in Korea. The cause of stress-induced cardiomyopathy is unclear, but catecholamines probably play a role in this syndrome. This entity could provide clues to the pathophysiology underlying stress-induced cardiomyopathy.

Acute Renal Failure Due to Severe Stenosis of Fibromuscular Dysplasia in a Single Kidney / 대한신장학회지

Among complications of fibromuscular dysplasia are uncontrolled hypertension, aneurysm and, albeit very rare, renal failure, especially in a single kidney. We report a case of severe stenosis of fibromuscular dysplasia leading to renal failure, in need of temporary hemodialysis in 29-year-old hypertensive woman. When she was 13-year-old, she underwent a left nephrectomy because of the left renal cyst and she was treated with antihypertensive medication for several years. A few day before admission, she complained of oliguria, generalized edema and aggravated dyspnea. On the day of admission, she took emergency hemodialysis. A renal angiogram showed focal irregular stenosis in the right proximal renal artery, compatible with fibromuscular dysplasia; therefore, we performed percutaneous renal artery angioplasty. Following successful renal angioplasty, her urine output increased and creatinine level was normalized.