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Takotsubo Cardiomyopathy in a Polytrauma Patient With Subarachnoid Hemorrhage
Takotsubo cardiomyopathy (TCM) is a sudden, transient myocardial stunning precipitated by severe emotional or physical stress. It is characterized by left ventricular apical ballooning and elevated cardiac enzymes without significant coronary artery stenosis. Stress-induced catecholamine surge has b...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10258542/ https://www.ncbi.nlm.nih.gov/pubmed/37313080 http://dx.doi.org/10.7759/cureus.38954 |
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author | Krishna, Mithun Murali Krishna, Mrinal Murali Joseph, Meghna |
author_facet | Krishna, Mithun Murali Krishna, Mrinal Murali Joseph, Meghna |
author_sort | Krishna, Mithun Murali |
collection | PubMed |
description | Takotsubo cardiomyopathy (TCM) is a sudden, transient myocardial stunning precipitated by severe emotional or physical stress. It is characterized by left ventricular apical ballooning and elevated cardiac enzymes without significant coronary artery stenosis. Stress-induced catecholamine surge has been proposed to be the likely mechanism of TCM. We report the case of a 23-year-old female who presented to the emergency department unconscious and in respiratory distress following a motor vehicle accident. The point-of-care ultrasonography showed prominent B lines in bilateral lung fields and a dilated inferior vena cava (IVC). An x-ray and computed tomography (CT) scan of the chest revealed bilateral diffuse ground glass opacities. A CT scan of the brain showed a subarachnoid hemorrhage (SAH). Electrocardiography (ECG) showed normal sinus rhythm, but troponin I was elevated. Echocardiography revealed left ventricular apical hypokinesia. The coronary angiogram was normal. A diagnosis of TCM with SAH was made. Appropriate emergent care was provided, and at follow-up, she made a complete cardiologic recovery. TCM is a puzzling condition in an emergency setting and accurate and timely diagnosis is imperative in the management. Early prevention of hypoxemia and maintenance of mean arterial pressure and cerebral perfusion pressure is critical in determining the long-term outcome of the patient in the setting of co-existing CNS pathologies. |
format | Online Article Text |
id | pubmed-10258542 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-102585422023-06-13 Takotsubo Cardiomyopathy in a Polytrauma Patient With Subarachnoid Hemorrhage Krishna, Mithun Murali Krishna, Mrinal Murali Joseph, Meghna Cureus Cardiology Takotsubo cardiomyopathy (TCM) is a sudden, transient myocardial stunning precipitated by severe emotional or physical stress. It is characterized by left ventricular apical ballooning and elevated cardiac enzymes without significant coronary artery stenosis. Stress-induced catecholamine surge has been proposed to be the likely mechanism of TCM. We report the case of a 23-year-old female who presented to the emergency department unconscious and in respiratory distress following a motor vehicle accident. The point-of-care ultrasonography showed prominent B lines in bilateral lung fields and a dilated inferior vena cava (IVC). An x-ray and computed tomography (CT) scan of the chest revealed bilateral diffuse ground glass opacities. A CT scan of the brain showed a subarachnoid hemorrhage (SAH). Electrocardiography (ECG) showed normal sinus rhythm, but troponin I was elevated. Echocardiography revealed left ventricular apical hypokinesia. The coronary angiogram was normal. A diagnosis of TCM with SAH was made. Appropriate emergent care was provided, and at follow-up, she made a complete cardiologic recovery. TCM is a puzzling condition in an emergency setting and accurate and timely diagnosis is imperative in the management. Early prevention of hypoxemia and maintenance of mean arterial pressure and cerebral perfusion pressure is critical in determining the long-term outcome of the patient in the setting of co-existing CNS pathologies. Cureus 2023-05-12 /pmc/articles/PMC10258542/ /pubmed/37313080 http://dx.doi.org/10.7759/cureus.38954 Text en Copyright © 2023, Krishna et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Cardiology Krishna, Mithun Murali Krishna, Mrinal Murali Joseph, Meghna Takotsubo Cardiomyopathy in a Polytrauma Patient With Subarachnoid Hemorrhage |
title | Takotsubo Cardiomyopathy in a Polytrauma Patient With Subarachnoid Hemorrhage |
title_full | Takotsubo Cardiomyopathy in a Polytrauma Patient With Subarachnoid Hemorrhage |
title_fullStr | Takotsubo Cardiomyopathy in a Polytrauma Patient With Subarachnoid Hemorrhage |
title_full_unstemmed | Takotsubo Cardiomyopathy in a Polytrauma Patient With Subarachnoid Hemorrhage |
title_short | Takotsubo Cardiomyopathy in a Polytrauma Patient With Subarachnoid Hemorrhage |
title_sort | takotsubo cardiomyopathy in a polytrauma patient with subarachnoid hemorrhage |
topic | Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10258542/ https://www.ncbi.nlm.nih.gov/pubmed/37313080 http://dx.doi.org/10.7759/cureus.38954 |
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