Cardiac sympathetic activity in stress-induced (Takotsubo) cardiomyopathy.
BACKGROUND
A 54-year-old postmenopausal woman presented with retrosternal chest pressure, nausea, and vomiting of 4 h duration. Her medical history included hypertension (treated with metoprolol and ramipril), hyperlipidemia (treated with atorvastatin), and depression (treated with fluoxetine). A few hours before symptom onset, she had witnessed an accident in which her sister sustained serious injuries. The patient was visiting her sister-who was in critical condition in the hospital-when the symptoms began.


METHODS
Physical examination, chest radiography, laboratory testing, electrocardiography, coronary angiography, and PET with 11C hydroxyephedrine.


METHODS
Stress-induced (Takotsubo) cardiomyopathy (apical ballooning syndrome).


RESULTS
The patient was monitored with cardiac telemetry. Metoprolol and ramipril were continued.
Prasad
Abhiram
A
Mayo Clinic, Rochester, Rochester, MN 55905, USA.
Madhavan
Malini
M
Chareonthaitawee
Panithaya
P
D000641:Ammonia; D002250:Carbon Radioisotopes; D017023:Coronary Angiography; D004562:Electrocardiography; D004809:Ephedrine / Q000031:analogs & derivatives; D005260:Female; D006321:Heart / Q000294:innervation*; D006801:Humans; D008875:Middle Aged; D009590:Nitrogen Radioisotopes; D049268:Positron-Emission Tomography; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D013686:Telemetry
D002250:Carbon Radioisotopes; D009590:Nitrogen Radioisotopes; C065363:3-hydroxyephedrine; D000641:Ammonia; D004809:Ephedrine