title: Pressure tracings in obstructive Tako-Tsubo cardiomyopathy.
abstract: A 70-year-old female experienced severe anxiety due to an incident with a stranger when she was home alone at night. Immediately after the event, she had an oppressive chest sensation; 16 h later she was admitted to hospital. Left ventriculography showed akinesia of the mid-to-distal portion and hyperkinesia of the basal portion of the left ventricular chamber. However, coronary angiography showed no significant coronary artery disease. We diagnosed her as having Tako-Tsubo cardiomyopathy. Subsequently, left ventricular and central aortic pressures were recorded simultaneously. Initial recording showed a peak systolic gradient of 60 mm Hg. On the first sinus beat after a premature ventricular contraction, the peak systolic gradient increased to 130 mm Hg, and the pulse pressure decreased. Shortly after intravenous administration of nitroglycerin (0.5 mg), central aortic pressure decreased and the peak systolic gradient increased to 100 mm Hg. On the first sinus beat after a premature ventricular contraction, the peak systolic gradient increased to 160 mm Hg, and the pulse pressure decreased. Five minutes after intravenous nitroglycerin, the peak systolic gradient returned to 70 mm Hg. Follow-up transthoracic echocardiography 13 days later showed normal left ventricular wall motion with no pressure gradient through the left ventricular outflow tract.
authors.affiliation: Department of Cardiology, Hiroshima City Hospital 7-33, Moto-machi, Naka-ku, Hiroshima 730-8518, Japan. skurisu@nifty.com <skurisu@nifty.com>
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurisu
authors.forename: Ichiro
authors.initials: I
authors.lastname: Inoue
authors.forename: Takuji
authors.initials: T
authors.lastname: Kawagoe
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimatani
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakama
authors.forename: Eisuke
authors.initials: E
authors.lastname: Kagawa
mesh_terms: D000368:Aged; D001794:Blood Pressure; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D009200:Myocardial Contraction / Q000502:physiology; D005996:Nitroglycerin / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin