An unusual case of broken heart syndrome

• Type: Summary of Presentation in an International Conference
• Date: 2012

Authors

Melão F (Author) FMUP; Freitas AT (Author) Other; Nunes JPL (Author) FMUP; Maciel MJ (Author) FMUP

Conference proceedings International

Title: European Journal of Heart Failure Supplements

Initial page: P837

Heart Failure Congress 2012

Belgrade, 2012

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Abstract (EN): Introduction: The stress-induced cardiomyopathy, also known as “broken heart syndrome” or Takotsubo cardiomyopathy (TM), is characterized by transient systolic dysfunction of the apical segment and /or middle of the left ventricle that mimics myocardial infarction, in the absence of obstructive coronary artery disease. Often there is a history of a recent emotional/physical stress or severe acute illness. Case report: A 64-year-old white man with history of chronic obstructive pulmonary disease (usually treated with tiotropium bromide, acetylcysteine and mometasone) presented with dyspnoea and cough with sputum. Pneumonia was diagnosed with left paratracheal consolidation. He had no respiratory insufficiency (RI). After treatment with ipratropium bromide, he had severe bronchospasm, and later retrosternal chest pain accompanied by sweating and pallor. Electrocardiogram (with pain) showed sinus tachycardia (HR 110), incomplete right bundle branch block, Q waves on DII, aVF, V3-V6 and ST-segment elevation of 2 mm in leads V1 through V3. Emergency cardiac catheterization disclosed no obstructive coronary artery disease. Left ventriculography showed systolic apical ballooning with mild basal hypercontraction. The echocardiogram revealed severe compromise of left ventricular systolic function (LVSF) and an apical aneurysm involving mid segments. Levels of creatine kinase-MB and troponin T were mildly elevated. After further use of ipratropium bromide, he developed marked bronchospasm and hypercapnic IR. One week later, echocardiography showed complete resolution of the wall motion abnormality and the LVSF. Cardiac magnetic resonance imaging didn't show delayed enhancement. Conclusion: This is a rare case not described in medical literature of TM secondary to ipratropium bromide.

Language: English

Type (Professor's evaluation): Scientific

Notes: Melão F, Freitas AT, Nunes JP, Maciel MJ. An unusual case of broken heart syndrome. Eur J Heart Fail Suppl 2012; 11(Suppl 1): P837. ISSN 1567-4215. Heart Failure Congress 2012, Belgrade, 2012