A case of neurogenic myocardial stunning presenting transient left ventricular mid-portion ballooning simulating atypical takotsubo cardiomyopathy.
A 57-year-old female patient, who was initially suspected to have subarachnoid hemorrhage, was admitted to our hospital. She experienced severe dyspnea and chest pain owing to pneumonia on the fourth admission day. Electrocardiography showed ST-segment elevation in leads V(2) through V(5), and echocardiography revealed hypokinetic left ventricular wall motion. No stenosis was found in the coronary arteries by urgent coronary angiography. However, left ventriculography revealed that the basal and apical areas were hyperkinetic and the mid portion was akinetic. After a month, left ventricular wall motion was improved and coronary artery spasm provocation tests were negative. Although the clinical course of this patient was similar to that of neurogenic myocardial stunning, the shape of her left ventricle was not typical.
Yamaguchi
Koji
K
Division of Cardiovascular Medicine, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima 770-8503, Japan. yamakoji3@hotmail.com
Wakatsuki
Tetsuzo
T
Kusunose
Kenya
K
Niki
Toshiyuki
T
Koshiba
Kunihiko
K
Yamada
Hirotsugu
H
Soeki
Takeshi
T
Akaike
Masashi
M
D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D017682:Myocardial Stunning / Q000175:diagnosis*; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis