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KMID : 0368120090390010037
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Korean Circulation Journal
2009 Volume.39 No. 1 p.37 ~ p.41
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Tako-Tsubo Cardiomyopathy by Transient Dynamic Left Midventricular Obstruction
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Hong Kyung-Wook
Park Dae-Gyun
Choi Hyun-Hee
Kim Sung-Eun
Yoon Duck-Hyoung
Lee Jun-Hee
Han Kyoo-Rok
Oh Dong-Jin
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Abstract
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A 48-year-old woman visited the emergency department with shock due to a urinary tract infection. The patient, who had a history of hypertension and diabetes mellitus, presented with precordial ST-segment elevation and Q waves, along with an increase of cardiac enzymes. An echocardiography showed moderately reduced systolic function, severe apical left ventricular ballooning, and a dynamic left ventricular outflow tract obstruction with a pressure gradient of 109 mmHg. Coronary angiography demonstrated normal coronary arteries. At the 1-month echocardiographic follow-up, the apical ballooning and left ventricular systolic function had recovered completely. There was no residual left ventricular intra-cavity gradient at rest, but it was induced in low-dose dobutamine stress-echocardiography. We demonstrated that dynamic left midventricular obstruction in the setting of either increased catecholamine stress or hypovolemia could develop Tako-tsubo cardiomyopathy.
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KEYWORD
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Tako-tsubo cardiomyopathy, Ventricular outflow obstruction, Echocardiography, stress
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