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Adukia, S.
- The Other Great Masquerader: Takotsubo Cardiomyopathy
Authors
1 Bharati Hospital and Research Center, Katraj, Dhankawadi, Pune-satara Road, Pune-411043, Maharashtra., IN
2 Department of Medicine, Bharati Hospital and Research Center, Katraj, Dhankawadi, Pune-satara Road, Pune-411043, Maharashtra., IN
Source
The Indian Practitioner, Vol 67, No 11 (2014), Pagination: 707-709Abstract
Takotsubo cardiomyopathy is a rare entity that mimics acute myocardial infarction or congestive heart failure. It is characterised by acute, transient, reversible left ventricular dysfunction that can mimic an acute coronary event at presentation. Coronary arteries are however, often normal on cardiac catheterisation. Patients are usually postmenopausal women who experience acute physical or emotional distress. For years this syndrome has been mistaken for acute myocardial infarction owing to a typical presentation with chest pain, electrocardiographic abnormalities, elevated cardiac enzymes and focal left ventricular wall motion abnormalities. Clinical diagnosis is difficult and demands a high index of suspicion. Recently proposed Mayo criteria might help in diagnosis. Delay in diagnosis should not result in delay in treatment. We report a case involving a post menopausal female who had an attack of takotsubo cardiomyopathy with a favourable outcome.Keywords
Reversible Cardiomyopathy, Mayo Criteria For Takotsubo Cardiomyopathy, Catecholamine Induced Ventricular Dysfunction
- Clinical Profile of Seronegative Spondyloarthropathies with Special Reference to Cardiac Involvement
Authors
1 Department of Medicine, Bharati Vidyapeeth University Medical College & Hospital, Pune - 411043, Maharashtra, IN
Source
The Indian Practitioner, Vol 68, No 10 (2015), Pagination: 25-32Abstract
Objectives: To study and to classify spondyloarthropathies and to determine the cardiac involvement in patients with spondyloarthropathy (SpA) by ECG and echocardiography.
Material and Methods: A cross-sectional observational study was conducted on 38 patients diagnosed as having seronegative SpA over 12 months. Patients were selected using screening score for diagnosis, detailed history and examination (to exclude arthropathies secondary to trauma, congenital heart defects, cardiac surgeries, other connective tissue diseases), and serological tests to exclude rheumatoid arthritis. Patients who were included, were then subjected to historical and clinical evaluation (including joint examination, dermatological and ocular examination), laboratory and radiological investigations alongwith ECG and echocardiography. The data was compiled and analysed using statistical package for social sciences (SPSS v/s 18).
Results: Out of 38 patients, male to female ratio was 2.45:1; 31.6% belonged to 21-30 years age group. 68.4% had symptoms of spondyloarthropathy since 1-10 years. Ankylosing spondylitis was the commonest SpA ocurring in 73.7%. Occurrence of articular manifestations was 100%; main joint affected was sacro-iliac joint alongwith spine in 92.1% followed by knee joint (87%), then ankle, shoulder, wrist and elbow joint in decreasing order of frequency. As opposed to this, extra articular manifestations were seen in 39.0%. ECG abnormalities such as ST segment changes and rhythm disturbances were noted in 6 patients with aortic regurgitation. ESR and CRP were raised in 90%. Echocardiography was normal in 21%. Among the rest, mitral valve involvement (prolapse, myxomatous valve, regurgitation) was highest (47.3%) followed by aortic valve (regurgitation, thickening, bicuspid aortic valve).