[Subarachnoid hemorrhage complicated with different manifestations of transient abnormal left ventricular wall motion: two case reports].
Two patients with subarachnoid hemorrhage presented with transient abnormal left ventricular wall motion. Case 1 was a 56-year-old man. Electrocardiography showed ST segment elevation in leads I, II, II, aVL, aVF, V3-V6. Echocardiography showed localized left ventricular hypokinesis around the apical area (takotsubo-like cardiomyopathy). Ejection fraction was 20% (1st hospital day). Troponin T was positive. Case 2 was a 48-year-old woman. Electrocardiography showed ST segment elevation in leads I, aVL, V2-V6 and ST segment depression in leads II, III, aVF, V1. Echocardiography showed diffuse left ventricular hypokinesis. Ejection fraction was 21% (1st hospital day). Troponin T was positive. These two patients had no history of cardiac disease, and coronary angiography showed no stenosis or obstruction. Catecholamine was given for 1 day(Case 1) and for about 2 weeks (Case 2). Pimobendane was given to Case 2. Ejection fraction was 57% in Case 1 (2nd hospital day) and 33% (6th hospital day), 43% (7th hospital day)and 58% (16th hospital day)in Case 2. The recovery period of left ventricular abnormal wall motion and the medication period were longer in Case 2 showing diffuse hypokinesis than in Case 1 showing takotsubo-like cardiomyopathy.
Inoue
Fumitaka
F
Department of Cardiology, Nara Prefectural Hospital, Nara.
Tsuzuki
Takashi
T
Thoma
Yoshiki
Y
Shiono
Shigeru
S
Tabuse
Hisayuki
H
Hoshida
Thoru
T
Saito
Yoshihiko
Y
D002316:Cardiotonic Agents / Q000627:therapeutic use; D002395:Catecholamines / Q000627:therapeutic use; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011724:Pyridazines / Q000627:therapeutic use; D013318:Stroke Volume; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D020107:Troponin T / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology*
D002316:Cardiotonic Agents; D002395:Catecholamines; D011724:Pyridazines; D020107:Troponin T; C041648:pimobendan