scholarly journals Myocardial Infarction or Takotsubo Cardiomyopathy? A Case Report of a Rare Clinical Dilemma in the Setting of Atrial Myxoma

2021 ◽  
Author(s):  
Balasubramaniyan Amirtha Ganesh ◽  
Sasinthar Rangasamy ◽  
Arumugam Aashish ◽  
Selvaraj Karthikeyan
Keyword(s):  
Myocardial Infarction ◽  
Takotsubo Cardiomyopathy ◽  
Acute Chest Pain ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Atrial Myxoma ◽  
Lv Function ◽  
St Segment Elevation ◽  
Coronary Embolization ◽  
Clinical Dilemma

Abstract Background Acute myocardial infarction (AMI) secondary to coronary embolization is one of the rare complications of atrial myxoma. Takotsubo cardiomyopathy (TCM), a close mimic of AMI, is extremely rare in the setting of atrial myxoma. We report a patient with atrial myxoma presenting with features leading to a clinical dilemma between these two entities. Case summary  A 60-year-old woman presented with acute chest pain with ST segment elevation. Echocardiogram revealed left ventricular (LV) apical ballooning which is typical of TCM, coexisting with a fragile left atrial mass. Emergency coronary angiogram showed a hazy lesion in the circumflex ostium and an intermediate lesion in ramus without any obstruction. Surgical excision of the tumor was done due to features of recurrent coronary embolism. The histopathology examination confirmed it as a myxoma. Regional wall motion abnormalities reversed within a month and LV function normalized. Cardiac magnetic resonance (CMR) imaging at follow-up suggested myocardial infarction. Discussion TCM can occur very rarely in the setting of atrial myxoma. In a patient with atrial myxoma presenting with features of TCM, differentiating it from coronary embolization is important.

scholarly journals Surgical treatment of left ventricular wall rupture, regarded as a consequence of Takotsubo cardiomyopathy

2017 ◽  
Vol 5 ◽  
pp. 2050313X1668921 ◽  
Author(s):  
Taalaibek Kudaiberdiev ◽  
Irina Akhmedova ◽  
Gulzada Imanalieva ◽  
Ildar Abdildaev ◽  
Kilichbek Jooshev ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Emotional Stress ◽  
Coronary Arteries ◽  
Takotsubo Cardiomyopathy ◽  
Laboratory Tests ◽  
Left Ventricular ◽  
Left Ventricular Aneurysm ◽  
Lv Function ◽  
Inferior Myocardial Infarction

Objective: We present the case of possible reverse type of TCM in a female patient presented with progressive left ventricular dysfunction and its rupture in pericardium. Methods: The detailed history, physical examination, laboratory tests, electrocardiography, serial echocardiography, coronary angiography with left ventriculography were performed to diagnose possible Takotsubo cardiomyopathy in 63-year old woman admitted to our center with complaints of dyspnea, lightheadedness, weakness and signs of hypotension and history of inferior myocardial infarction, acute left ventricular aneurysm, and effusive pericarditis and pleuritis, developed after emotional stress 5 months ago. Results: Clinical evaluation revealed unremarkable laboratory tests, normal troponin values, signs of old inferior myocardial infarction on electrocardiogram, and left ventricular (LV) dilatation and dysfunction, akinesia of LV infero-lateral wall with thinning and its rupture and blood shunting in pericardium. Her coronary angiography revealed normal coronary arteries. The diagnosis of pheochromocytoma was excluded. The patient underwent surgery under cardiopulmonary bypass with removal of LV pseudoaneurysm. The patient was discharged from hospital with improvement in NYHA class and LV function. Conclusion: Thus, in female postmenopausal patients presenting with acute myocardial infarction signs complicated by pericarditis, intact coronary arteries and LV dysfunction with emotional stress as triggering factor, reverse type of TCM should be considered and proper management applied to prevent development of life-threatening complications like LV rupture.

scholarly journals Can a pneumothorax break your heart?

2015 ◽  
Vol 24 (1) ◽  
pp. 55-8 ◽  
Author(s):  
Stylianos Mavridis ◽  
Hans-Georg Gnauk ◽  
Silvio Horn ◽  
Peter Adeberg ◽  
Martina Schumacher ◽  
...  
Keyword(s):  
Takotsubo Cardiomyopathy ◽  
Ventricular Dysfunction ◽  
Troponin I ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Air Leakage ◽  
St Segment Elevation ◽  
St Segment ◽  
Electrocardiographic Findings ◽  
Significant Coronary Stenosis

Takotsubo cardiomyopathy or apical ballooning is a condition characterized by transitory left ventricular dysfunction, affecting commonly postmenopausal females after foregoing acute emotional or physical stress. We report a case of a 63 year old female presenting with severe dyspnea and right-sided secondary spontaneous pneumothorax, initially treated with tube thoracostomy. Despite the fact that pneumothorax resolved, shortness of breath persisted and due to ST-segment elevation and increased Troponin I levels, she was admitted to cardiac catheterization. A significant coronary stenosis was ruled out and the diagnosis of a Takotsubo cardiomyopathy was established. Electrocardiographic findings were normalized within three days and attributable to prolonged air leakage. A thoracoscopic apex resection followed by a partial parietal pleurectomy was performed. Although Takotsubo cardiomyopathy is a rare syndrome, it should always be considered as a potential cardiac complication of a pneumothorax.

scholarly journals Bone marrow mesenchymal stem cells transfer in patients with ST-segment elevation myocardial infarction: single-blind, randomized controlled muticentre trial

2020 ◽  
Author(s):  
Runfeng Zhang ◽  
Jiang Yu ◽  
Ningkun Zhang ◽  
Wensong Li ◽  
Jisheng Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
General Hospital ◽  
Myocardial Viability ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Function ◽  
St Segment Elevation ◽  
Lv Ejection Fraction

Abstract Objective: Our aimed to evaluate efficacy and safety of intracoronary autologous bone morrow mesenchymal stem cells (BM-MSCs) transplantation in patients with ST-segment elevation myocardial infarction（STEMI）. Methods: In this randomised, single-blind, controlled trial, patients with STEMI (aged 39-76 years) were enrolled at 6 centers in Beijing (the People's Liberation Army Navy General Hospital, Beijing Armed Police General Hospital, Chinese People's Liberation Army General Hospital, Beijing Huaxin Hospital, Beijing Tongren Hospital, Beijing Chaoyang Hospital West Hospital). Patients underwent optimum medical treatment and percutaneous coronary intervention,and were randomly assigned in a 1:1 ratio to BM-MSCs group or control group. The primary endpoint was change of myocardial viability at 6 months' follow-up and left-ventricular (LV) function at 12 months' follow-up.The secondary endpoints were incidence of cardiovascular event, total mortality and adverse event at 12 months' follow-up. The myocardial viability assessed by single- photon emission tomography (SPECT). The left ventricular ejection fraction was used to assess LV function. All patients underwent dynamic ECG and laboratory evaluations. This trial is registered with ClinicalTrails.gov, number NCT04421274. Results: Between March , 2008, and July , 2010, 43 patients were randomly assigned to BM-MSCs group (n=21)or control group(n=22) and followed up for 12 months. LV ejection fraction increased from baseline to 12 months in the BM-MSCs group and control group ( mean baseline-adjusted BM-MSCs treatment differences in LV ejection fraction 4.8% (SD 9.0) and mean baseline-adjusted control group treatment differences in LV ejection fraction 5.8% (SD 6.04) ). After 6 months of follow-up, there was no significant improvement in myocardial metabolic activity in the BM-MSCs group before and after transplantation. however,there was no statistically significant difference between the two groups in the change of LV ejection fraction (p=0.30) and myocardial metabolic activity(p>0.05). We noticed that ,after 12 months of follow-up, except for 1 death and 1 coronary microvascular embolism in the BM-MSCs group, no other events occurred and Alanine transaminase(ALT) and C-reactive protein(CRP) in BM-MSCs group were significantly lower than that in control group. Conclusions: It is unreasonable to speculate that intracoronary transfer of autologous bone marrow MSCs could augment recovery of LV function and myocardial viability after acute myocardial infarction.Trial registration: clinicaltrials,NCT04421274. Registered 06,08,2020- Retrospectively registered, https://register.clinicaltrials.gov/NCT04421274.

Clinical and Diagnostic Aspects of Takotsubo Cardiomyopathy

2011 ◽  
Vol 3 (1) ◽  
pp. 60
Author(s):  
Yoshihiro J Akashi ◽  
Giuseppe Barbaro ◽  
Fumihiko Miyake ◽  
◽  
◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Takotsubo Cardiomyopathy ◽  
Elderly Women ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Anterior Myocardial Infarction ◽  
Diagnostic Aspects ◽  
The World ◽  
Ventricular Rupture

In recent years, the number of documented cases of takotsubo cardiomyopathy, which occurs mainly in elderly women, has been increasing all over the world. Takotsubo cardiomyopathy presents quite similar symptoms to acute anterior myocardial infarction, but with normal coronary arteries and left ventricular apical ballooning. Takotsubo cardiomyopathy has been recognised as a source of acute heart failure, lethal ventricular arrhythmia and ventricular rupture. The onset mechanism of this syndrome is still a matter of debate. In this article, we summarise previous studies and future issues regarding takotsubo cardiomyopathy.

P3095Left ventricular thrombus formation after ST-elevation myocardial infarction: a prospective observational CMR study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Holzknecht ◽  
S J Reinstadler ◽  
M Reindl ◽  
C Tiller ◽  
A Mayr ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin T ◽  
Thrombus Formation ◽  
Multivariable Analysis ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Lv Function ◽  
Culprit Lesion ◽  
St Segment Elevation ◽  
Systolic Volume

Abstract Background Left ventricular (LV) thrombus formation is a severe complication after acute ST-segment elevation myocardial infarction (STEMI). The incidence and determinants of LV thrombus formation are still a matter of controversy. Purpose We aimed to assess the incidence as detected by cardiac magnetic resonance (CMR) imaging as well as the determinants of LV thrombus formation in contemporary reperfused STEMI patients. Methods This prospective observational study included 530 consecutive STEMI patients treated with primary percutaneous coronary intervention (PCI). Comprehensive CMR was performed at a median of 3 days (interquartile range 2–4 days) after symptom onset for the evaluation of LV thrombus formation as well as LV function and infarct severity. Results LV thrombi were detected in 17 patients (3.2% of the overall cohort). The incidence of LV thrombi in anterior STEMI patients (n=247) was 6.9%. In all patients presenting with LV thrombus left anterior descending artery (LAD) was identified as culprit lesion. The occurrence of thrombi was significantly associated with reduced LV ejection fraction (LVEF) (p<0.001), larger LV end-diastolic volume (p<0.001) and LV end-systolic volume (p<0.001), larger areas of microvascular obstruction (MVO) (p=0.003) and larger infarct size (IS) (p<0.001). Furthermore, increased levels of peak high sensitivity cardiac Troponin T (p<0.001) and hyperlipidaemia (p=0.038) were significantly related to LV thrombi. In multivariable analysis including IS, LVEF and MVO, only LVEF (odds ratio: 0.91 (95% confidence interval: 0.87–0.96); p=0.001) emerged as independent predictor of LV thrombus formation. Conclusion The risk of LV thrombus formation remains considerable in contemporary treated STEMI patients, especially in those with LAD as culprit lesion. Among CMR parameters of LV dysfunction and infarct severity, only baseline LVEF, but not IS or MVO, independently predicted LV thrombus formation after STEMI.

scholarly journals Takotsubo Cardiomyopathy in Two Patients without Any Cardiac Symptom on Maintenance Hemodialysis

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Jun Muratsu ◽  
Atsuyuki Morishima ◽  
Hiroyasu Ueda ◽  
Hisatoyo Hiraoka ◽  
Katsuhiko Sakaguchi
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Takotsubo Cardiomyopathy ◽  
Clinical Symptoms ◽  
Apical Ballooning ◽  
Left Ventricular ◽  
Maintenance Hemodialysis ◽  
Cardiac Symptom ◽  
Electrocardiographic Changes ◽  
Artery Disease

Takotsubo cardiomyopathy is a disorder characterized by left ventricular apical ballooning and electrocardiographic changes in the absence of coronary artery disease. While reversible in many cases, the mechanism of this disorder remains unclear. The most frequent clinical symptoms of takotsubo cardiomyopathy on admission are chest pain and dyspnea, resembling acute myocardial infarction. Here, we describe two cases of takotsubo cardiomyopathy without chest pain or dyspnea in patients on maintenance hemodialysis. The asymptomatic nature of these two cases may be due to the patients being on hemodialysis. Periodic electrocardiograms (ECG) may be helpful in screening this population for asymptomatic takotsubo cardiomyopathy and in evaluating its incidence.

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