title: Takotsubo syndrome in a patient after renal transplantation.
abstract: BACKGROUND
  Takotsubo syndrome (TTS) is a transient cardiomyopathy of unknown origin, clinically manifesting as acute coronary syndrome (ACS). This syndrome mainly occurs in postmenopausal women and has a temporary relationship with emotional or physical stress.
  
  
  METHODS
  TTS occurred in 46-year-old female patient on the first day after renal transplantation. The predominant symptoms were connected with ACS, performed with low grade troponin elevation and characteristic shape of left ventricle depicted in echocardiography. Taking into consideration the risk of the development of contrast-induced nephropathy, coronary angiography (CA) was delayed; myocardial perfusion scintigraphy and iodine-123 metaiodobenzylguanidine (¹²³I-mIBG) myocardial uptake were performed to confirm the clinical suspicion. Myocardial perfusion scintigraphy (MPS) performed in rest condition showed normal perfusion but myocardial uptake of ¹²³I-mIBG was impaired. Within 6 months after surgery, full recovery of all biochemical and functional parameters of the left ventricle were observed. At that time CA was done, depicting normal coronary arteries.
  
  
  CONCLUSIONS
  TTS could be diagnosed by the use of non-nephrotoxic tests - ¹²³I-mIBG myocardial scintigraphy, MPS and echocardiography.
authors.affiliation: Chair and Department of Nuclear Medicine, Medical University of Lublin, Lublin, Poland. beata.chrapko@wp.pl
authors.forename: Beata E
authors.initials: BE
authors.lastname: Chrapko
authors.forename: Andrzej
authors.initials: A
authors.lastname: Tomaszewski
authors.forename: Andrzej J
authors.initials: AJ
authors.lastname: Jaroszyński
authors.forename: Jacek
authors.initials: J
authors.lastname: Furmaga
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wysokiński
authors.forename: Sławomir
authors.initials: S
authors.lastname: Rudzki
mesh_terms: D019797:3-Iodobenzylguanidine; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D016030:Kidney Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000209:etiology*
chemical_list: D007457:Iodine Radioisotopes; D019797:3-Iodobenzylguanidine