title: An atypical evolution of tako-tsubo cardiomyopathy.
abstract: An 83-year-old woman with a possible history of myocardial infarction presented with acute chest pain and dyspnoea. The electrocardiogram showed no signs of acute coronary syndrome, but Q waves in the anteroseptal leads. The blood tests showed an important elevation of troponin T level. Emergency coronary angiography revealed normal epicardial arteries, but the left ventriculogram demonstrated anterior akinesis and ballooning with normal apical and basal function. An atypical takotsubo cardiomyopathy was suspected and the patient received beta blocker and ACE inhibitor treatment. Two days later the echocardiogram evolved to a classical pattern of apical ballooning with normalization on the follow-up examination 5 weeks from the acute episode. To our knowledge, this is the first case report describing an evolving pattern of wall motion abnormality from an anterior wall ballooning to an apical form.
authors.affiliation: Dept. of Cardiology, Brugmann UH Brussels, Belgium. mihai.strachinaru@chu-brugmann.be
authors.forename: Mihai
authors.initials: M
authors.lastname: Strachinaru
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Tran-Ngoc
authors.forename: Nasroolla
authors.initials: N
authors.lastname: Damry
authors.forename: Isabela
authors.initials: I
authors.lastname: Costescu
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D017023:Coronary Angiography / Q000379:methods; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D054549:Takotsubo Cardiomyopathy / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome; D020107:Troponin T / Q000097:blood
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D020107:Troponin T