ABSTRACT
We report a case of an 82-year-old female presenting with symptoms of chest pain, nausea, dizziness and electrocardiographic evidence of ST segment elevation in inferior and ST depression in anterior leads. Emergent coronary angiogram showed totally occluded mid left circumflex and a totally occluded distal right coronary artery, there was no response to intracoronary nitroglycerin before intervention. Both arteries were successfully ballooned and stented. Multiple cases of simultaneous coronary occlusion has been reported and different mechanisms has been postulated but exact mechanism is still not well understood.
Subject(s)
Coronary Thrombosis/complications , Myocardial Infarction/etiology , Aged, 80 and over , Coronary Angiography , Coronary Thrombosis/diagnosis , Echocardiography , Electrocardiography , Female , Humans , Myocardial Infarction/diagnosisABSTRACT
Apical ballooning (takotsubo syndrome) mimics acute myocardial infarction with transient apical dyskinesia and normal coronary arteries. It is often precipitated by emotional or physical stress. The prevalence of this syndrome has been increasing, probably because it is now more frequently recognized. Multiple theoretical hypotheses have been developed to explain its genesis, but the mechanism remains unclear. Rarely, cases of apical sparing and other wall motion involvement have been cited. We collected data on 12 patients who had acute myocardial infarction and normal coronary arteries with abnormal wall motion that had completely healed on repeat studies. Five patients had typical apical ballooning, and the other 7 had wall motion abnormalities in other segments. We determined that stress-induced cardiomyopathy can involve any wall of the myocardium and is not always apical ballooning.
Subject(s)
Myocardium/pathology , Stress, Physiological/complications , Stress, Psychological/complications , Takotsubo Cardiomyopathy/physiopathology , Ventricular Function, Left , Adult , Aged , Coronary Angiography , Coronary Vessels/pathology , Echocardiography , Electrocardiography , Female , Humans , Male , Middle Aged , Stress, Physiological/blood , Stress, Physiological/pathology , Stress, Physiological/physiopathology , Stress, Psychological/blood , Stress, Psychological/pathology , Stress, Psychological/physiopathology , Takotsubo Cardiomyopathy/blood , Takotsubo Cardiomyopathy/etiology , Takotsubo Cardiomyopathy/pathology , Troponin/blood , Ventricular PressureABSTRACT
We report a patient with an evidence of bilateral calf deep vein thrombosis, hemodynamically significant pulmonary embolism, and echocardiographic evidence of right heart thromboemboli with "popcorn" appearance. She responded well to thrombolytics and low molecular weight heparin with resolution of symptoms and improvement of echocardiographic abnormalities.
