Critical takotsubo cardiomyopathy complicated by ventricular septal perforation.
An 81-year-old woman was admitted with chest pain. An electrocardiogram demonstrated ST segment elevation in leads II, III and aVF, and echocardiography revealed left ventricular apical asynergy with a left-to-right ventricular shunt. Meanwhile, emergent coronary angiography showed no significant coronary artery stenosis, whereas left ventriculography indicated apical ballooning and a left-to-right ventricular shunt. We therefore diagnosed the patient with Takotsubo cardiomyopathy complicated by ventricular septal perforation and cardiogenic shock. An electrocardiogram disclosed a prolonged QT interval over time, and the patient became hemodynamically stable under treatment with inotropes; however, she suddenly developed fatal ventricular fibrillation three days after hospitalization. Takotsubo cardiomyopathy complicated by ventricular septal perforation is a critical condition that requires careful monitoring.
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Japan.
Tadao
T
Aikawa
Mamoru
M
Sakakibara
Masayuki
M
Takahashi
Kyoko
K
Asakawa
Yutaka
Y
Dannoura
Takao
T
Makino
Tetsuro
T
Koya
Hiroyuki
H
Tsutsui
D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D004562:Electrocardiography; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D012770:Shock, Cardiogenic / Q000175:diagnosis* / Q000209:etiology*; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis*; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000209:etiology*; D018658:Ventricular Septal Rupture / Q000175:diagnosis* / Q000209:etiology*