Viability assessment by multidetector computed tomography in Takotsubo cardiomyopathy.

Stress-induced cardiomyopathy, known as Takotsubo, is an increasingly recognized syndrome, characterized by transient apical or midventricular dysfunction, which mimics myocardial infarction in the absence of significant coronary artery disease, and is thought to be due to transient catecholamine overload. Multidetector computed tomography (MDCT) is a novel imaging approach increasingly recognized as a rapid, noninvasive diagnostic modality to assess coronary anatomy and cardiac function. Few reports have been published regarding its utility in the assessment of myocardial viability after myocardial infarction. We describe 2 patients with Takotsubo cardiomyopathy who underwent MDCT imaging. To our knowledge, this is the first report describing the utility of MDCT that shows the absence of delayed hyperenhancement in patients with Takotsubo cardiomyopathy.

Late spontaneous epigastric arterial bleeding associated with abciximab: successful percutaneous treatment with coil gel-foam embolization.

We describe a case of spontaneous hemorrhage from a branch of the right inferior epigastric artery, unrelated to the access site. This complication occurred in association with the administration of abciximab. Prompt identification of this unusual complication resulted in successful bleeding control using coil and gel-foam embolization. Our purpose is to draw attention to yet another potentially catastrophic adverse side effect of abciximab infusion. To our knowledge, spontaneous rupture of an inferior epigastric artery during abciximab therapy has not been previously reported. In addition, the treatment of such an artery with coil and gel-foam has not been previously described. As with the other described complications, due diligence is required so that spontaneous arterial bleeding can be identified and swift intervention be taken.