A rare case of tako-tsubo cardiomyopathy complicated by a left ventricular thrombus.
Tako-tsubo cardiomyopathy is a rare stress-related cardiomyopathy usually seen in postmenopausal women after an emotional stressor. Patients generally present with angina-like substernal chest pain. The electrocardiogram (ECG) shows ST segment elevation or T wave inversions across the anterior precordial leads. Cardiac markers are minimally elevated, without evidence of coronary artery disease on angiography. The ventriculogram demonstrates hypokinesis and ballooning of the apex with hyperkinesis of the base. Prognosis is favorable with normalization of wall motion abnormalities within weeks. We present a rare case tako-tsubo cardiomyopathy complicated by a left ventricular mural thrombus. It is thought that this thrombus may have been precipitated by the ventricular dyskinesis. Further research is needed to determine the true incidence of left ventricular thrombus and the role of short-term anticoagulant therapy in this disorder.
Tibrewala
Amit V
AV
Washington Hospital Center, Department of Medicine, Suite 2A-38 N, 110 Irving Street, NW, Washington, DC 20010, USA. tibrewala@gmail.com
Moss
Brian N
BN
Cooper
Howard A
HA
D009202:Cardiomyopathies / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008875:Middle Aged; D013315:Stress, Psychological / Q000150:complications*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology*