Congestive Heart FailureTako-tsubo-like left ventricular dysfunction with ST-segment elevation: A novel cardiac syndrome mimicking acute myocardial infarction*
Section snippets
Patients
From September 1983 to July 2001, a total of 30 patients with tako-tsubo-like left ventricular dysfunction on contrast left ventriculogram were retrospectively enrolled in this study. Tako-tsubo-like left ventricular dysfunction was defined as hypokinesis or akinesis from the mid portion to the apical area and hyperkinesis of the basal area, which extended over more than one coronary artery region. Patients with idiopathic cardiomyopathy, pheochromocytoma, or prior myocardial infarction were
Clinical and ECG findings
Clinical characteristics are presented in Table I.Case Age (y)/sex Diabetes Hypertension Prior angina Other disorder Trigger event Chief complaint ST-segment elevation T-wave inversion 1 63/F − − Rest - Singing in public Chest pain I, aVL, V5-V6 II, III, aVF, V4-V6 2 69/F − + - Rheumatoid arthritis Gastric endoscopy Chest pain V3-V6 V3-V6 3 60/M − − Rest - - Dyspnea II, III, aVF, V2-V4 - 4 68/F − − Rest - - Chest discomfort I, aVL, V2-V6 - 5 74/F − + - - - Chest discomfort III, aVF - 6 72/F − − - Bronchial asthma Asthma attack
Present findings
Since we first proposed the term “tako-tsubo-like left ventricular dysfunction,” in view of its peculiar asynergy on contrast left ventriculogram in 1991,1 it has been widely recognized in Japan.2, 3, 4, 5 Because tako-tsubo-like left ventricular dysfunction is rare, clinical features remain unclear. In the current study, we demonstrated that (1) most patients with tako-tsubo-like left ventricular dysfunction were elderly women; (2) symptoms were similar to that of acute myocardial infarction,
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Reprint requests: Satoshi Kurisu, MD, Division of Cardiology, Hiroshima City Hospital, 7-33, Moto-machi, Naka-ku, Hiroshima, Japan 730-8518. E-mail: [email protected]