ED echo of reverse Tako-tsubo cardiomyopathy: a rare and misleading finding.
Tako-tsubo transient cardiomyopathy (TCM) is a syndrome of specific myocardial wall motion abnormalities that appear in response to extreme physiological or emotional stress. The patients have normal coronary arteries and usually present as new-onset heart failure or acute coronary syndrome. We report on a 48-year-old woman with post-community cardiac arrest presenting as an acute myocardial infarction. An emergency physician–performed echocardiogram showed significant wall motion abnormalities, suggesting myocardial infarction. Cardiac catheterization revealed patent epicoronary circulation, and ventriculography demonstrated a rare and only recently described variant of TCM:“reverse” TCM. The patient subsequently died from a subarachnoid hemorrhage.
Department of Emergency Medicine, Wellington Hospital, Wellington South 6242, New Zealand. sbomann@msn.com
Scott
S
Bomann
Iain O
IO
Davies
D006328:Cardiac Catheterization; D004452:Echocardiography; D004636:Emergency Service, Hospital; D017809:Fatal Outcome; D005260:Female; D006321:Heart / Q000503:physiopathology; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology; D013345:Subarachnoid Hemorrhage / Q000150:complications; D054549:Takotsubo Cardiomyopathy / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology