Aims: Left ventricular apical ballooning syndrome (LVABS) is a clinical condition of unknown etiology, characterized by acute onset of atypical apical wall motion and absence of coronary artery disease. Gadolinium-enh...Aims: Left ventricular apical ballooning syndrome (LVABS) is a clinical condition of unknown etiology, characterized by acute onset of atypical apical wall motion and absence of coronary artery disease. Gadolinium-enhanced cardiac magnetic resonance imaging (Gd-MRI) may be used to identify patients with myocarditis. Using cardiac MRI, we evaluated whether acute myocarditis may be an etiology that underlies LVABS. Methods and Results: Consecutive patients who presented with LVABS during a three-year period were included. Demographic data was recorded and echocardiography, coronary angiography, and hemodynamic assessment performed. Gd-MRI was performed in all patients. The study was deemed consistent with myocarditis when global myocardial to skeletal muscle enhancement ratio was ≥3.5. Regional Gd-MRI analysis was also performed. Patients (n = 11) were female (100%) and of mean age 72 years (72 ± 11). Preceding febrile illness occurred in 4 (36.3%) and leukocytosis in 6 (54.4%) patients. Initial mean left ventricular ejection fraction (41% ± 12%) improved (70.2% ± 8%) upon follow-up (39 ± 43 days). Global MRI analysis was positive in 5/11 (45.5%) (mean relative enhancement ratio 4.8 ± 1.4). Regional MRI analysis was positive in 4/6 further patients (overall: 9/11 (82%)). Conclusions: Gadolinium enhanced MRI imaging in LVABS implicates myocarditis as a possible etiology. Regional MRI analysis adds sensitivity to global cardiac MRI evaluation.展开更多
Transient apical ballooning syndrome（Tako-Tsubo syndrome or ampulla cardiomyopathy） occurs predominantly in women over 60 years of age with a history of recent physical or psychological stress. We present a case of ...Transient apical ballooning syndrome（Tako-Tsubo syndrome or ampulla cardiomyopathy） occurs predominantly in women over 60 years of age with a history of recent physical or psychological stress. We present a case of a male patient with reversible transient apical ballooning syndrome with significant coronary lesions and other ECG changes that did not explain the clinical symptoms.展开更多
Apical hypertrophic cardiomyopathy (apical HCM) is a rare variant of hypertrophic cardiomyopathy with a prevalence of 1% - 2% in Asian population and carries a benign prognosis. It is usually silent in early stages an...Apical hypertrophic cardiomyopathy (apical HCM) is a rare variant of hypertrophic cardiomyopathy with a prevalence of 1% - 2% in Asian population and carries a benign prognosis. It is usually silent in early stages and manifests in adults with a suspicion of typical ECG changes of giant T wave inversion in left precordial leads. Transthoracic echocardiography is the mainstay of non-invasive diagnosis and provides a heterogeneous appearance of its morphological features with a spade-shaped LV (left ventricular) cavity. Background of this case study describes the apical HCM in an asymptomatic male at the age of 54 years old and also predicts the mixed and mid-ventricular forms of left ventricular HCM at this region of Thoothukudi in India.展开更多
Takotsubo syndrome （transient left ventricular apical ballooning syndrome） is a novel cardiac syndrome of left ventricular apical ballooning involving reversible left ventricular apical ballooning （during systole）...Takotsubo syndrome （transient left ventricular apical ballooning syndrome） is a novel cardiac syndrome of left ventricular apical ballooning involving reversible left ventricular apical ballooning （during systole） of acute onset with chest pain, electrocardiographic changes, and minimal elevation of cardiac enzymes resembling acute myocardial infarction, but without evidence of myocardial ischemia or injury.展开更多
We present the case of an 86-year-old woman referred to us from Orthopaedics Division after surgical treatment for femur fracture without personal or family history of ischemic cardiopathy. During hospitalization the ...We present the case of an 86-year-old woman referred to us from Orthopaedics Division after surgical treatment for femur fracture without personal or family history of ischemic cardiopathy. During hospitalization the patient had stomach-ache and the electrocardiogram demonstrated ST-segment elevation in anterior leads. The coronarography showed haziness, but no critical stenosis;ventricolography revealed apical ballooning of the left ventricle with severe systolic dysfunction. She was treated with dopamine in renal dose, beta-blockers and warfarin. When she was in fairly good condition, she started physiotherapy for endoprosthesis for the femur fracture. Clinicians should consider takotsubo cardiomyopathy in the differential diagnosis of patients presenting with chest pain, especially in women with a recent history of physical stress.展开更多
文摘Aims: Left ventricular apical ballooning syndrome (LVABS) is a clinical condition of unknown etiology, characterized by acute onset of atypical apical wall motion and absence of coronary artery disease. Gadolinium-enhanced cardiac magnetic resonance imaging (Gd-MRI) may be used to identify patients with myocarditis. Using cardiac MRI, we evaluated whether acute myocarditis may be an etiology that underlies LVABS. Methods and Results: Consecutive patients who presented with LVABS during a three-year period were included. Demographic data was recorded and echocardiography, coronary angiography, and hemodynamic assessment performed. Gd-MRI was performed in all patients. The study was deemed consistent with myocarditis when global myocardial to skeletal muscle enhancement ratio was ≥3.5. Regional Gd-MRI analysis was also performed. Patients (n = 11) were female (100%) and of mean age 72 years (72 ± 11). Preceding febrile illness occurred in 4 (36.3%) and leukocytosis in 6 (54.4%) patients. Initial mean left ventricular ejection fraction (41% ± 12%) improved (70.2% ± 8%) upon follow-up (39 ± 43 days). Global MRI analysis was positive in 5/11 (45.5%) (mean relative enhancement ratio 4.8 ± 1.4). Regional MRI analysis was positive in 4/6 further patients (overall: 9/11 (82%)). Conclusions: Gadolinium enhanced MRI imaging in LVABS implicates myocarditis as a possible etiology. Regional MRI analysis adds sensitivity to global cardiac MRI evaluation.
文摘Transient apical ballooning syndrome（Tako-Tsubo syndrome or ampulla cardiomyopathy） occurs predominantly in women over 60 years of age with a history of recent physical or psychological stress. We present a case of a male patient with reversible transient apical ballooning syndrome with significant coronary lesions and other ECG changes that did not explain the clinical symptoms.
文摘Apical hypertrophic cardiomyopathy (apical HCM) is a rare variant of hypertrophic cardiomyopathy with a prevalence of 1% - 2% in Asian population and carries a benign prognosis. It is usually silent in early stages and manifests in adults with a suspicion of typical ECG changes of giant T wave inversion in left precordial leads. Transthoracic echocardiography is the mainstay of non-invasive diagnosis and provides a heterogeneous appearance of its morphological features with a spade-shaped LV (left ventricular) cavity. Background of this case study describes the apical HCM in an asymptomatic male at the age of 54 years old and also predicts the mixed and mid-ventricular forms of left ventricular HCM at this region of Thoothukudi in India.
文摘Takotsubo syndrome （transient left ventricular apical ballooning syndrome） is a novel cardiac syndrome of left ventricular apical ballooning involving reversible left ventricular apical ballooning （during systole） of acute onset with chest pain, electrocardiographic changes, and minimal elevation of cardiac enzymes resembling acute myocardial infarction, but without evidence of myocardial ischemia or injury.
文摘We present the case of an 86-year-old woman referred to us from Orthopaedics Division after surgical treatment for femur fracture without personal or family history of ischemic cardiopathy. During hospitalization the patient had stomach-ache and the electrocardiogram demonstrated ST-segment elevation in anterior leads. The coronarography showed haziness, but no critical stenosis;ventricolography revealed apical ballooning of the left ventricle with severe systolic dysfunction. She was treated with dopamine in renal dose, beta-blockers and warfarin. When she was in fairly good condition, she started physiotherapy for endoprosthesis for the femur fracture. Clinicians should consider takotsubo cardiomyopathy in the differential diagnosis of patients presenting with chest pain, especially in women with a recent history of physical stress.
