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Takotsubo cardiomyopathy and coronary artery disease: value of cardiac magnetic resonance imaging for diagnostic confirmation: a case report

BACKGROUND: Takotsubo cardiomyopathy (TCM) is a reversible acute cardiac disease that mimics acute myocardial infarction (AMI). In patients with a history of an old myocardial infarction who develop TCM, cardiac magnetic resonance imaging (CMRI) is the first-line non-invasive diagnostic tool for cle...

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Autores principales: Díaz-Navarro, Rienzi, Villagran, Francisco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439425/
https://www.ncbi.nlm.nih.gov/pubmed/31020227
http://dx.doi.org/10.1093/ehjcr/yty151
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author Díaz-Navarro, Rienzi
Villagran, Francisco
author_facet Díaz-Navarro, Rienzi
Villagran, Francisco
author_sort Díaz-Navarro, Rienzi
collection PubMed
description BACKGROUND: Takotsubo cardiomyopathy (TCM) is a reversible acute cardiac disease that mimics acute myocardial infarction (AMI). In patients with a history of an old myocardial infarction who develop TCM, cardiac magnetic resonance imaging (CMRI) is the first-line non-invasive diagnostic tool for clearly discriminating between AMI and TCM. CASE SUMMARY: A 65-year-old woman who suffered a myocardial infarction in 2012, was admitted to undergo sigmoid colon tumour surgery in January 2017. Soon after surgery, she developed angina associated with ST-segment elevation, as shown by electrocardiography and increased cardiac enzyme levels. Acute coronary syndrome was diagnosed. She had a good clinical response to treatment with intravenous nitroglycerine, opioids, clopidogrel, aspirin, bisoprolol, and atorvastatin. Transthoracic echocardiography (TTE) showed anteroseptal and apical left ventricular akinesia with balloon-like dilatation, akinesia of the inferior wall and inferior interventricular septum, and global systolic dysfunction. Coronary angiography did not identify coronary artery lesions, and a tentative diagnosis of TCM was made. Cardiac magnetic resonance imaging confirmed the segmental contraction abnormalities seen in the TTE and identified myocardial oedema without delayed hyperenhancement after gadolinium administration, which confirmed the diagnosis of TCM and ruled out acute ischaemic damage. She was discharged when asymptomatic. Cardiac magnetic resonance imaging at 2 months showed disappearance of the anteroseptal and apical contraction abnormality, regression of myocardial oedema and normalization of global left ventricular systolic function. DISCUSSION: This case confirms that CMRI is a non-invasive diagnostic method for accurately differentiating between AMI and TCM in patients with a prior myocardial infarction. cardiac magnetic resonance imaging should be incorporated as a diagnostic criterion for TCM.
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spelling pubmed-64394252019-04-24 Takotsubo cardiomyopathy and coronary artery disease: value of cardiac magnetic resonance imaging for diagnostic confirmation: a case report Díaz-Navarro, Rienzi Villagran, Francisco Eur Heart J Case Rep Case Reports BACKGROUND: Takotsubo cardiomyopathy (TCM) is a reversible acute cardiac disease that mimics acute myocardial infarction (AMI). In patients with a history of an old myocardial infarction who develop TCM, cardiac magnetic resonance imaging (CMRI) is the first-line non-invasive diagnostic tool for clearly discriminating between AMI and TCM. CASE SUMMARY: A 65-year-old woman who suffered a myocardial infarction in 2012, was admitted to undergo sigmoid colon tumour surgery in January 2017. Soon after surgery, she developed angina associated with ST-segment elevation, as shown by electrocardiography and increased cardiac enzyme levels. Acute coronary syndrome was diagnosed. She had a good clinical response to treatment with intravenous nitroglycerine, opioids, clopidogrel, aspirin, bisoprolol, and atorvastatin. Transthoracic echocardiography (TTE) showed anteroseptal and apical left ventricular akinesia with balloon-like dilatation, akinesia of the inferior wall and inferior interventricular septum, and global systolic dysfunction. Coronary angiography did not identify coronary artery lesions, and a tentative diagnosis of TCM was made. Cardiac magnetic resonance imaging confirmed the segmental contraction abnormalities seen in the TTE and identified myocardial oedema without delayed hyperenhancement after gadolinium administration, which confirmed the diagnosis of TCM and ruled out acute ischaemic damage. She was discharged when asymptomatic. Cardiac magnetic resonance imaging at 2 months showed disappearance of the anteroseptal and apical contraction abnormality, regression of myocardial oedema and normalization of global left ventricular systolic function. DISCUSSION: This case confirms that CMRI is a non-invasive diagnostic method for accurately differentiating between AMI and TCM in patients with a prior myocardial infarction. cardiac magnetic resonance imaging should be incorporated as a diagnostic criterion for TCM. Oxford University Press 2018-12-22 /pmc/articles/PMC6439425/ /pubmed/31020227 http://dx.doi.org/10.1093/ehjcr/yty151 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Reports
Díaz-Navarro, Rienzi
Villagran, Francisco
Takotsubo cardiomyopathy and coronary artery disease: value of cardiac magnetic resonance imaging for diagnostic confirmation: a case report
title Takotsubo cardiomyopathy and coronary artery disease: value of cardiac magnetic resonance imaging for diagnostic confirmation: a case report
title_full Takotsubo cardiomyopathy and coronary artery disease: value of cardiac magnetic resonance imaging for diagnostic confirmation: a case report
title_fullStr Takotsubo cardiomyopathy and coronary artery disease: value of cardiac magnetic resonance imaging for diagnostic confirmation: a case report
title_full_unstemmed Takotsubo cardiomyopathy and coronary artery disease: value of cardiac magnetic resonance imaging for diagnostic confirmation: a case report
title_short Takotsubo cardiomyopathy and coronary artery disease: value of cardiac magnetic resonance imaging for diagnostic confirmation: a case report
title_sort takotsubo cardiomyopathy and coronary artery disease: value of cardiac magnetic resonance imaging for diagnostic confirmation: a case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439425/
https://www.ncbi.nlm.nih.gov/pubmed/31020227
http://dx.doi.org/10.1093/ehjcr/yty151
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