[Tako-Tsubo syndrome in a patient with exacerbated bronchial asthma]. / Síndrome Tako-Tsubo en una paciente con exacerbación de asma bronquial.

Transient apical ballooning syndrome without coronary stenosis or Tako-Tsubo syndrome was described a few years ago in a Japanese population. Although new cases and series have been gradually defining its physiopathology, there is much doubt about its etiology. We describe the case of a 74-year-old Caucasian woman, with a background of hypertension, type 2 diabetes mellitus and hyperthyroidism with tracheal compression, intrinsic asthma and depression syndrome. She had an acute attack of bronchospasm and chest pain. The electrocardiogram on admission showed Q-waves and ST segment elevation in precordial leads and elevated serum cardiac markers. The coronariography found no evidence of significant lesions in the vascular tree. Ventriculography showed an apical ballooning that was also found in the echocardiography. The evolution of the clinical picture with disappearance of the symptoms and normalization of the electrocardiogram and echocardiogram lead to the diagnosis of Tako-Tsubo syndrome. We believe that this new clinical entity may have a catecholamine-mediated neurogenic mechanism as the etiopathogenic substrate and that our clinical case could support this hypothesis.

Síndrome Tako-Tsubo en una paciente con exacerbación de asma bronquial / Tako-Tsubo syndrome in a patient with exacerbated bronchial asthma

El síndrome de disquinesia apical transitoria sin lesiones coronarias o síndrome Tako-Tsubo se ha descrito hace unos años, pero persisten dudas sobre su etiología, aunque la presentación de nuevos casos y series lo ha ido definiendo poco a poco. Describimos el caso de una mujer de 74 años, con historial previo de hipertensión arterial, diabetes mellitus tipo 2, bocio hipertiroideo con compresión traqueal, asma intrínseco y síndrome depresivo, que presentó exacerbación de su asma, con dolor torácico. A su ingreso en el hospital el electrocardiograma mostraba ondas Q y elevación del segmento ST en derivaciones precordiales; asimismo se observó elevación de los marcadores enzimáticos cardíacos. La angiografía coronaria demostró la ausencia de anomalías, presentando una disquinesia apical, observada igualmente en el ecocardiograma. La evolución del cuadro clínico con desaparición de la sintomatología y normalización del electrocardiograma y ecocardiograma llevaron al diagnóstico de síndrome Tako-Tsubo. Creemos que esta nueva entidad clínica puede tener una base etiopatogénica neurogénica mediada por catecolaminas y el caso presentado apoya dicha tesis (AU)

Transient apical ballooning syndrome without coronary stenosis or Tako-Tsubo syndrome was described a few years ago in a Japanese population. Although new cases and series have been gradually defining its physiopathology, there is much doubt about its etiology. We describe the case of a 74-year-old Caucasian woman, with a background of hypertension, type 2 diabetes mellitus and hyperthyroidism with tracheal compression, intrinsic asthma and depression syndrome. She had an acute attack of bronchospasm and chest pain. The electrocardiogram on admission showed Q-waves and ST segment elevation in precordial leads and elevated serum cardiac markers. The coronariography found no evidence of significant lesions in the vascular tree. Ventriculography showed an apical ballooning that was also found in the echocardiography. The evolution of the clinical picture with disappearance of the symptoms and normalization of the electrocardiogram and echocardiogram lead to the diagnosis of Tako-Tsubo syndrome. We believe that this new clinical entity may have a catecholamine-mediated neurogenic mechanism as the etiopathogenic substrate and that our clinical case could support this hypothesis (AU)

Derrame pericárdico severo como primera manifestación de un carcinoma tímico / Severe pericardial effusion as the first sign of thymus carcinoma

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Mixoma auricular y carcinoma de colon / Auricular mixoma and colon carcinoma

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