Document Detail

Reversible cardiogenic shock in an angry woman--case report and review of the literature.
MedLine Citation:
PMID:  8689541     Owner:  NLM     Status:  MEDLINE    
A previously healthy woman presented with ischemic cardiac pain and ST elevation suggestive of acute myocardial infarction following a 45 min argument. Despite receiving tissue plasminogen activator, she developed cardiogenic shock and objective evidence of recurrent ischemia, with only a small creatine kinase rise. Angiography revealed the unexpected findings of normal coronary anatomy and akinesis of the distal two-thirds of the left ventricle. Apart from an iliac vein thrombosis, the remainder of her course was characterized by dramatic recovery of cardiac function. The differential diagnosis of myocardial infarction with angiographically normal coronary arteries is discussed, with emphasis on aspects relevant to this case. The presence of high titre anticentromere antibodies, anticardiolipin antibodies, protein S deficiency and supportive physical findings, suggested the diagnosis of concurrent antiphospholipid antibody syndrome (with secondary acquired protein S deficiency) and CREST syndrome. The pathogenesis likely involved an interaction between stress, vasospasm, and thrombosis.
K A Kovacs; G W Burggraf; C L Dewar
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  12     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  1996 Jul 
Date Detail:
Created Date:  1996-08-26     Completed Date:  1996-08-26     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  689-93     Citation Subset:  IM    
Division of Cardiology, Queen's University, Kingston, Ontario.
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MeSH Terms
Anger / physiology*
Antiphospholipid Syndrome / complications
CREST Syndrome / complications*,  diagnosis
Diagnosis, Differential
Middle Aged
Myocardial Infarction / diagnosis
Shock, Cardiogenic / etiology*
Stress, Psychological / complications*

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