A successful treatment of a case of Takotsubo cardiomyopathy complicated with left ventricular free-wall rupture
█ Case report
DOI: 10.26430/CHUNGARICA.2023.53.1.52
Authors:
Moisza Sunita1, Sváb Marianna1, Béres Zoltán1, Mandzák Ákos2,
Takács Gergely2, Szerafin Tamás2, Kőszegi Zsolt1, 2
1Szabolcs Szatmár Bereg Megyei Kórházak és Egyetemi Oktatókórház,
Jósa András Oktatókórház, Kardiológiai Osztály, Nyíregyháza
2Debreceni Egyetem Klinikai Központ, Kardiológiai és Szívsebészeti Klinika, Szívsebészeti Klinika, Debrecen
Levelezési cím:
Dr. Moisza Sunita, 4400 Nyíregyháza, Szent István út 68. E-mail cím: moisasunita@yahoo.com
Summary
Takotsubo cardiomyopathy is a condition which resembles a suddenly-occurring, acute coronary syndrome, which is mostly triggered by emotional or physical stress. A 65-year-old hypertensive, diabetic, depressed female patient was admitted to our department with recurrent chest complaints and suspected myocardial infarction. The heart ultrasound showed the akinesis of the middle and distal segments of the left ventricle as well as the apex. The basal segments were hyperkinetic and the ejection fraction was markedly reduced.Based on the visual image our assumption was Takotsubo cardiomyopathy. The coronary angiography confirmed patent epicardial arteries. A few hours after the cardiac catheterisation, her chest pains recurred. Soon after cardiogenic shock developed caused pericardial tamponade confirmed by cardiac ultrasound. Therefore we performed an urgent pericardiocentesis. At the top of the left chamber, near the lateral wall an attaching hematoma of 10×5 millimetres in diameter was detected on the repetaed echocardiography, in the course of which some blood flow also detectable. Due to this finding diagnosis of ventricular free wall rupture was established therefore the patient was transferred to the Department of Cardiac Surgery. An emergency operation was performed, during which the perforation of the left chamber was closed with a Tachosil patch. Postoperative echocardiography showed neither wall motion abnormality, nor pericardial effusion. We considered our case worth presenting, since Takotsubo cardiomyopathy complicated with free-wall rupture is an extremely rare associated with high mortality. In our opinion the early recognition of this condition has a crucial role in the successful treatment.
ISSUE: CARDIOLOGIA HUNGARICA | 2023 | VOLUME 53, ISSUE 1
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