title: Right ventricular involvement and pulmonary hypertension in an elderly woman with tako-tsubo cardiomyopathy.
abstract: We describe a case of tako-tsubo cardiomyopathy in an elderly woman with a permanent pacemaker admitted to the ED with chest pain and dyspnea. Coronary angiography revealed normal coronary arteries. Typical left ventricular apical ballooning was demonstrated on contrast ventriculography. Left and right ventricular ballooning with pulmonary artery systolic hypertension was detected by transthoracic echocardiography. Velocity vector imaging and strain analysis showed a typical pattern of regional myocardial apical right ventricular contraction characterized by paradoxical positive longitudinal systolic strain. Biventricular involvement was associated with hemodynamic instability, signs of pulmonary vascular congestion, and bilateral basal pleural effusion. The patient's clinical condition gradually improved, and she was discharged after prolonged hospitalization. Predischarge echocardiography showed substantial recovery of left and right systolic function along with normalization of pulmonary artery systolic pressure. Right ventricular function should be carefully evaluated in patients with tako-tsubo cardiomyopathy, especially in the acute phase.
authors.affiliation: Via Matteo Rossi, 7, 84127 Salerno, Italy. rodolfocitro@tele2.it
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Citro
authors.forename: Ilaria
authors.initials: I
authors.lastname: Caso
authors.forename: Gennaro
authors.initials: G
authors.lastname: Provenza
authors.forename: Michele
authors.initials: M
authors.lastname: Santoro
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gregorio
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
mesh_terms: D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D017380:Hypertrophy, Right Ventricular / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D009200:Myocardial Contraction / Q000502:physiology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology