Tako-tsubo-like left ventricular dysfunction with ST-segment elevation after central spinal cord injury: a case report.
The etiology of a novel cardiac syndrome called "tako-tsubo" cardiomyopathy, otherwise known as "acute onset and reversible left ventricular apical wall motion abnormality (ballooning)," is very similar to that of acute myocardial infarction; however, it may also be associated with emotional or physical stress. We report a case of tako-tsubo-like left ventricular dysfunction with ST-segment elevation after trauma. A 69-year-old man was transferred to our hospital after a fall in which he injured his back. He was diagnosed with a central spinal cord injury and was admitted to our Intensive Care Unit. He complained of a sudden chest pain 12 h after the injury. ST-segment elevation was observed on the electrocardiographic monitor, and subsequent 12-lead electrocardiogram demonstrated ST-segment elevation in leads V(2) through V(5). We considered acute myocardial infarction or cardiac contusion to be the cause of this event; therefore, an emergency coronary angiography was performed. However, the angiography revealed no significant coronary artery stenosis. Furthermore, left ventriculography demonstrated severe hypokinesis of the left ventricular apical region, consistent with tako-tsubo-like left ventricular dysfunction. The patient's cardiac function improved gradually, and he was discharged from our hospital on the 18(th) day after admission. Physicians should recognize the syndrome of tako-tsubo-like left ventricular dysfunction, which may result from traumatic stress or chest injury.
Morita
Seiji
S
Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Isehara-City, Kanagawa, Japan.
Inokuchi
Sadaki
S
Yamagiwa
Takeshi
T
Aoki
Hiromichi
H
Nakagawa
Yoshihide
Y
Yamamoto
Isotoshi
I
D000058:Accidental Falls; D000368:Aged; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013124:Spinal Injuries / Q000150:complications*; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000209:etiology*; D014057:Tomography, X-Ray Computed