ABSTRACT
Takotsubo cardiomyopathy (TCM) is characterised by reversible left ventricular dysfunction in patients presenting with acute coronary syndrome (ACS). TCM is considered multifactorial, and the repetitive exposure to inhaled beta-2-agonists has been suspected to induce TCM in predisposed individuals. We report two cases of TCM in female patients presenting with ACS both exposed to inhaled beta-2-agonists. Eccocardiography revealed apical ballooning and reduced left ventricular function. Coronary angiography was with no significant stenosis. Both patients recovered by anticongestive treatment.
Subject(s)
Adrenergic beta-2 Receptor Agonists , Takotsubo Cardiomyopathy/chemically induced , Administration, Inhalation , Adrenergic beta-2 Receptor Agonists/administration & dosage , Adrenergic beta-2 Receptor Agonists/adverse effects , Aged , Aged, 80 and over , Echocardiography , Electrocardiography , Female , Humans , Takotsubo Cardiomyopathy/diagnosis , Takotsubo Cardiomyopathy/diagnostic imaging , Takotsubo Cardiomyopathy/therapyABSTRACT
Giant coronary aneurysms (GCA with a diameter > 20 mm) are rare with a prevalence < 0.02%. A 62-year-old woman with no history of ischaemic heart disease was admitted to hospital with acute chest pain. A coronary angiography revealed a left an-terior descendent-associated GCA. A cardiac computed tomo-g-raphy demonstrated a "snake-pit"-like fistula connecting the GCA and the pulmonary artery. Atherosclerosis, connective tissue dis-orders, and previous coronary intervention will predispose to GCA. No evidence-based treatment regimen exists, but coiling, excision or a conservative approach, as in this case, is possible strategies.
