| Intractable cardiogenic shock in stress cardiomyopathy with left ventricular outflow tract obstruction: is extra-corporeal life support the best treatment? | |
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MedLine Citation:
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PMID: 19468019 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We report the use of extra-corporeal cardiopulmonary support (ECLS), in a case of complicating refractory severe cardiogenic shock, in a patient with Tako-tsubo cardiomyopathy (TC). Tako-tsubo cardiomyopathy syndrome is characterized by left ventricular (LV) wall motion abnormalities, usually without coronary artery disease, mimicking the diagnosis of acute coronary syndrome. This ventricular dysfunction is typically reversible in the acute phase, though it can progress into refractory cardiogenic shock with limited therapeutic options available. Here, we report for the first time in a Tako-tsubo patient with refractory cardiogenic shock, the use of ECLS treatment in order to unload the heart, sustain circulation and end-organ perfusion, and promote potential ventricular recovery. Extra-corporeal life support allowed inotropic drug weaning while maintaining end-organ function and supported the patient until myocardial recovery. The patient recovered completely, and a normal LV ejection fraction was documented by 2D echocardiography on day 7. From our experience, ECLS can be an appropriate treatment for severe refractory cardiogenic shock in patients with TC. Extra-corporeal life support was an effective ultimate solution. |
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Authors:
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Massimo Bonacchi; Massimo Maiani; Guy Harmelin; Guido Sani |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2009-05-24 |
Journal Detail:
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Title: European journal of heart failure Volume: 11 ISSN: 1388-9842 ISO Abbreviation: Eur. J. Heart Fail. Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-06-25 Completed Date: 2010-09-21 Revised Date: 2011-06-08 |
Medline Journal Info:
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Nlm Unique ID: 100887595 Medline TA: Eur J Heart Fail Country: Netherlands |
Other Details:
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Languages: eng Pagination: 721-7 Citation Subset: IM |
Affiliation:
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Cardiac Surgery, Medical and Surgical Critical Care Department, University of Florence, 50134 Firenze, Italy. massimo.bonacchi@unifi.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Extracorporeal Membrane Oxygenation* Female Hemodynamics Humans Recovery of Function Shock, Cardiogenic / diagnosis, etiology, therapy* Stroke Volume Takotsubo Cardiomyopathy / complications, therapy* Ventricular Dysfunction, Left / therapy Ventricular Function, Left Ventricular Outflow Obstruction / complications, therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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