title: [De novo left ventricular thrombus during tako-tsubo cardiomyopathy].
abstract: METHODS
  A 70-year-old woman complained of persistent angina pectoris and exertional dyspnoea after a fierce row with a dog owner. Five days after the conflict she visited our clinic.
  
  
  METHODS
  The ECG showed T-wave inversions across the inferior and anterior leads as well as a prolonged QTc interval (490 ms). NTproBNP was elevated (6733 ng/l) while troponin T was normal. Echocardiography and ventriculography during cardiac catheterisation demonstrated an impaired left ventricular function (EF 55 %) with apical akinesia. Coronary artery disease was ruled out by coronary angiography. Based on these findings stress-related cardiomyopathy (Tako-tsubo syndrome) was diagnosed.
  
  
  METHODS
  Guideline-based therapy of heart failure was performed. At control examination 13 days after the initial event left ventricular function had improved but now a new left ventricular apical thrombus was detected. Therefore, oral anticoagulation therapy was started.
  
  
  CONCLUSIONS
  In cases of tako-tsubo cardiomyopathy with apical akinesia it should be noted that a left ventricular thrombus can develope within few days.
authors.affiliation: Klinik III für Innere Medizin, Uniklinik Köln, Köln. guido.michels@uk-koeln.de
authors.forename: G
authors.initials: G
authors.lastname: Michels
authors.forename: R
authors.initials: R
authors.lastname: Pfister
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D013927:Thrombosis / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy