title: [Transient left ventricular apical akinesis with systolic dysfunction after physical exercise: a form of tako-tsubo syndrome].
abstract: A 43-year-old woman with mild hypertension and type-2 diabetes mellitus was presented to the coronary care unit because of ongoing chest pain and associated dyspnea after physical exercise. On arrival, her ECG disclosed ST-segment elevations in the precordial leads. The emergent cardiac catheterization failed to demonstrate coronary artery disease. The prompt performed transthoracic echocardiogram demonstrated systolic dysfunction with apical ballooning. Akinetic segments were irrespective of coronary artery anatomy. Laboratory tests revealed only slightly elevated cardiac enzymes: we observed a significant discrepancy between the extent of akinesis and the minimal increase in cardiac necroenzymes. The patient was medically managed and discharged in stable condition, with follow-up at 4 weeks demonstrating nearly total recovery of cardiac function and total resolution of wall motion disorder. Her clinical presentation is consistent with that of tako-tsubo cardiomyopathy, a syndrome that is characterized by transient apical regional wall motion abnormalities in the absence of epicardial coronary artery disease. Main precipitating factor is thought to be the cathecolamin excess due to emotional or physical stress, subarachnoid hemorrhage, phaeochromocytoma or cocaine use. The authors report the first physical exercise induced tako-tsubo syndrome in the Hungarian medical literature.
authors.affiliation: Gottsegen György Országos Kardiológiai Intézet, Budapest.
authors.forename: Márton
authors.initials: M
authors.lastname: Vértesaljai
authors.forename: Sándor
authors.initials: S
authors.lastname: Szoke
authors.forename: Tibor
authors.initials: T
authors.lastname: Szonyi
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Piróth
authors.forename: Géza
authors.initials: G
authors.lastname: Fontos
authors.forename: Krisztina
authors.initials: K
authors.lastname: Szüts
authors.forename: Margit
authors.initials: M
authors.lastname: Szegedi
authors.forename: Tamás
authors.initials: T
authors.lastname: Böhm
authors.forename: Péter
authors.initials: P
authors.lastname: Andréka
mesh_terms: D000328:Adult; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D015444:Exercise; D005260:Female; D006801:Humans; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology