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Chavan, C.
- The Other Great Masquerader: Takotsubo Cardiomyopathy
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Authors
Affiliations
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
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- Fibrinolysis in STEMI-A Second Thought
Abstract Views :177 |
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Authors
Affiliations
1 Bharati Hospital And Research Center, Katraj, Dhankawadi, Pune-Satara Road, Pune-411043, IN
1 Bharati Hospital And Research Center, Katraj, Dhankawadi, Pune-Satara Road, Pune-411043, IN
Source
The Indian Practitioner, Vol 69, No 8 (2016), Pagination: 37-39Abstract
Cardiac sarcoidosis (CS) is an infrequent element of systemic sarcoidosis, manifesting in upto 2% cases of sarcoidosis, but found in upto 25% of these on autopsy. Despite a plethora of tools such as ECG, echocardiography, cardiac MRI, PET scan, endomyocardial biopsy (EMB), accurate antemortem diagnosis of CS remains a challenge. Pathological hallmark of CS is a noncaseating epitheloid granuloma, either microscopic or macroscopic. It causes conduction defects manifesting on ECG as a variety of arrhythmias or non-specific ST-T segment changes. Uncommon amongst these is an ST segment elevation mimicking myocardial infarction (MI). This triggers an urge for fibrinolysis if a proper history and other confirmatory biochemical markers are not sought. We report a previously healthy male presenting with chest discomfort and progressive breathlessness, and with ECG suggestive of ST segment elevation myocardial infarction (STEMI). Fibrinolytic therapy was spared owing to a high index of suspicion for CS against a background of detailed history and incoherent biochemistry. CS was confirmed by cardiac MRI and endomyocardial biopsy. Partial remission of symptoms was observed after steroid therapy alongwith anti-arrhythmics.References
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