title: Cardiac arrest caused by Barlow's syndrome or by stress cardiomyopathy?
abstract: We describe a case of out-of-hospital Cardiac Arrest (CA) in a patient with Barlow's Syndrome (BS) and features of Stress Cardiomyopathy (SC) (or Apical Ballooning Syndrome or Tako-Tsubo). The patient experienced CA during physical stress and was resuscitated thanks to DC-Shock. The Electrocardiogram (ECG) after resuscitation was unremarkable. In the reported case the documented severe hypokalemia, with the physical stress, could have triggered the CA, probably of tachyarrhythmic origin. However, in the reported case, the echocardiographic, coronarographic and ventriculographic features, were surprisingly indistinguishable from those of the SC. In conclusion it is impossible to say if, in our patient, the CA has been caused by BS or by SC. However, even if CA has been probably caused by the BS, we hypothesize that the CA, in its turn determined, might have caused the SC via stress mechanisms. In few words, the CA is a complication of SC, but should probably be regarded also as a cause of SC.
authors.forename: Antonio
authors.initials: A
authors.lastname: Facciorusso
authors.forename: Cesare
authors.initials: C
authors.lastname: Amico
authors.forename: Carlo
authors.initials: C
authors.lastname: Vigna
authors.forename: Tiberio
authors.initials: T
authors.lastname: Santoro
authors.forename: Domenico
authors.initials: D
authors.lastname: Potenza
authors.forename: Raimondo
authors.initials: R
authors.lastname: Massaro
authors.forename: Mario
authors.initials: M
authors.lastname: Stanislao
authors.forename: Guido
authors.initials: G
authors.lastname: Valle
authors.forename: Lucio
authors.initials: L
authors.lastname: Cavaliere
authors.forename: Raffaele
authors.initials: R
authors.lastname: Fanelli
mesh_terms: D000328:Adult; D002395:Catecholamines / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D007008:Hypokalemia / Q000150:complications; D008945:Mitral Valve Prolapse / Q000150:complications*; D054549:Takotsubo Cardiomyopathy / Q000150:complications*
chemical_list: D002395:Catecholamines