title: ECG pattern in reverse takotsubo cardiomyopathy demonstrated in 5 cases with intracranial hemorrhage.
abstract: In typical takotsubo cardiomyopathy (TC) apical transient left ventricular dysfunction with concomitant ECG changes mimicking acute anterior myocardial infarction can be observed. Reverse TC (RTC) characterized by contractile disturbances in all basal and often simultaneous mid-ventricular segments is definitely less frequent. ECG pattern of RTC is less known. The authors present ECG findings in 5 cases of RTC in course of intracranial hemorrhage (ICH); 3 patients were diagnosed with subarachnoid hemorrhage (SAH) and the other two with intracerebral hemorrhage or subdural posttraumatic hematoma. In all patients, initial ECG appearance was dominated by ST segment depression in inferior leads (II, III, avF) and/or lateral leads (V4-6). In 4 patients, concurrent ST segment elevation in avR and avL leads was seen, additionally 4 patients had low QRS voltage in high lateral leads (I, avL). Potential normalization of these changes did not influence the patient`s survival. In one woman, immediately before death, early repolarization was recorded. In subjects with an increased risk of TC, for example in intracranial hemorrhage, particularly in SAH, the ECG abnormalities presented may indicate a need for further search of its atypical echocardiographic variants.
authors.affiliation: Józef Struś Hospital, Poznań, Poland: Department of Internal Medicine.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Elikowski
authors.affiliation: Poznań University of Medical Sciences, Poland: 2nd Department of Cardiology.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Małek-Elikowska
authors.affiliation: Józef Struś Hospital, Poznań, Poland:Department of Anesthesiology and Intensive Therapy.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Kudliński
authors.affiliation: Józef Struś Hospital, Poznań, Poland: Radiology Unit.
authors.forename: Paweł
authors.initials: P
authors.lastname: Skrzywanek
authors.affiliation: Józef Struś Hospital, Poznań, Poland: Department of Neurosurgery.
authors.forename: Sławomir
authors.initials: S
authors.lastname: Smól
authors.affiliation: Józef Struś Hospital, Poznań, Poland: Department of Anesthesiology and Intensive Therapy.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Rzymski
mesh_terms: D000293:Adolescent; D000328:Adult; D004562:Electrocardiography; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications*; D008297:Male; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult
keywords: ECG; echocardiography; intracranial hemorrhage; reverse takotsubo cardiomyopathy