title: Apical ballooning syndrome associated with isolated severe hyponatremia: case report and suggested pathophysiology.
abstract: An 82-year-old woman who presented to her primary care physician for preoperative evaluation was incidentally found to have severe hyponatremia (sodium = 118 mmol/L). The patient was then admitted for workup and treatment of hyponatremia. On day 2 of the admission, the patient was found to have new T-wave inversions on a telemetry monitor. Further workup, including an electrocardiogram, cardiac markers, echocardiogram, and a cardiac catheterization were consistent with the diagnosis of apical ballooning syndrome (ABS). Mechanisms of how severe hyponatremia may lead to ABS are discussed as well as a possible approach to the management of severe hyponatremia in postmenopausal women.
authors.affiliation: University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Ofer
authors.initials: O
authors.lastname: Sagiv
authors.forename: Sasa
authors.initials: S
authors.lastname: Vukelic
authors.forename: Steve
authors.initials: S
authors.lastname: Czak
authors.forename: Frank
authors.initials: F
authors.lastname: Messineo
authors.forename: Neil L
authors.initials: NL
authors.lastname: Coplan
mesh_terms: D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis*; D033162:Incidental Findings; D012720:Severity of Illness Index; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy