title: Takotsubo cardiomyopathy associated with syncope.
abstract: We report an 81-year-old Japanese patient with takotsubo cardiomyopathy associated with syncope with the possibility that the latter event evoked the former condition. Initial investigations revealed elevation of cardiac enzymes and electrocardiography changes consistent with acute myocardial infarction. The patient subsequently underwent cardiac catheterization that revealed left ventricular apical ballooning and decreased left ventricular ejection fraction without significant coronary artery lesions. A marked elevation in plasma norepinephrine, as a result of baroreflex unloading associated with profound hypotension or frank baroreflex failure, may well have caused takotsubo cardiomyopathy.
authors.affiliation: Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96813, USA.
authors.forename: Licheng
authors.initials: L
authors.lastname: Lee
authors.forename: Thana
authors.initials: T
authors.lastname: Khawcharoenporn
authors.forename: Nalurporn
authors.initials: N
authors.lastname: Chokrungvaranon
authors.forename: Gail
authors.initials: G
authors.lastname: Peterson
mesh_terms: D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002216:Captopril / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004562:Electrocardiography; D005260:Female; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D007022:Hypotension; D009638:Norepinephrine / Q000097:blood; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy; D013575:Syncope / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D005665:Furosemide; D002216:Captopril; D009638:Norepinephrine