|
KMID : 0368120020320121054
|
|
Korean Circulation Journal
2002 Volume.32 No. 12 p.1054 ~ p.1063
|
|
|
Clinical Manifestation of Novel Stress-induced Cardiomyopathy Mimicking Acute Myocardial Infarction：Single Center Prospective Registry
|
|
이호현/Ho Hyun Lee
권현철/김병진/임을순/원경헌/이경진/성지동/이상철/박승우/김덕경/이상훈/서정돈/Hyeon Cheol Gwon/Byung Jin Kim/Kyung Jin Lee/Eul Soon Im/Kyung Hun Won/Ji Dong Sung/Sang Chul Lee/Seung Woo Park/Duk Kyung Kim/Sang Hoon Lee/Jung Don Seo
|
|
|
Abstract
|
|
|
Background and Objectives: The so-called 'stress-induced cardiomyopathy' or takotsubo cardiomyopathy, mimicking acute myocardial infarction (AMI), has recently been reported, particularly in Japan. We prospectively studied the clinical characteristics of, for the first time with a Korean series, this novel syndrome.
Subjects and Methods: Eighteen patients, fore filling the inclusion criteria, were entered onto the study. The criteria for inclusion were：1) no previous history of cardiac disease, 2) acute onset, 3) a regional wall motion abnormality in the left ventriculogram, typically in the apical segment, and 4) no significant stenosis in the coronary angiogram.
Results: The events preceding the condition included：emotional stress (N＝7), acute illness (N＝5), non-cardiac surgery or medical procedure (N＝4) and accident (N＝2). Chest pain, dyspnea, or nausea/vomiting were initially noted in 12 cases (66%). Pulmonary edema was demonstrated in 10 (56%), and cardiogenic shock in 4 (23%) of the patients. The peak creatinine kinase MB fraction was 69±136 Iμ/ℓ. A T wave inversion was noted in all patients, whereas, a Q wave was noted transiently in only 1. The average left ventricular ejection fraction (LVEF) was 38±8% on the initial echocardiograms. On the left ventriculograms, 15 patients showed akinetic wall motion, or aneurysmal dilatation in the apical wall, however, notably in 3 patients in the mid-ventricular wall. The coronary vasospasm provocation tests were negative in all 10 patients tested. An intravascular ultrasonography showed no infarct-related plaques in the 4 patients examined. On a follow-up echocardiogram, the average LVEF was improved to 51±8%, and regional wall motion was normalized after 30±29 days following onset.
Conclusion: We report, for the first time in a series of Korean patients, on a novel stress-induced cardiomyopathy with transient regional wall motion abnormality, mimicking AMI. The precise etiology remains to be elucidated in further studies.
|
|
|
KEYWORD
|
|
|
Stress, Cardiomyopathy, congestive, Myocardial infarction, Myocardial stunning,
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
   
|
|