Document Detail

A case of apical ballooning syndrome in a male with status asthmaticus; highlighting the role of B2 agonists in the pathophysiology of a reversible cardiomyopathy.
MedLine Citation:
PMID:  23882408     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Apical ballooning syndrome (ABS), also known as Takotsubo cardiomyopathy, was first reported by Dote and colleagues in Japanese literature in 1991 in a review of five cases. Case series have highlighted the association of severe psychological stressors as the major precipitating factors of this syndrome. Status Epilepticus and Sub-Arachnoid hemorrhage are also now established independent etiologies for this phenomenon in patients without coronary artery disease. We report a case of reversible apical ventricular dysfunction in a 50-year-old male presenting with status asthmaticus who quickly underwent intubation. Following this, he had ST elevations in precordial leads with mild cardiac enzyme leak. Subsequent cardiac catheterization revealed a left ventricular ejection fraction of 25-30% with apical aneurismal segment. No obstructive disease was observed. Three days later there was marked clinical improvement; the patient was extubated and repeat echocardiography revealed a remarkable return to normal ventricular size and systolic function. Our case demonstrates that excess use of beta-agonists may be a potential risk factor for ABS and raises the possibility of cathecholamine cardiotoxicity being mediated via beta-receptors. Furthermore, it also negates the propensity of apical ballooning so far reported only in women with respiratory distress without confounding emotional stressors.
Farah F Salahuddin; Peter Sloane; Philip Buescher; Lev Agarunov; Divya Sreeramoju
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Publication Detail:
Type:  Journal Article     Date:  2013-07-05
Journal Detail:
Title:  Journal of community hospital internal medicine perspectives     Volume:  3     ISSN:  2000-9666     ISO Abbreviation:  J Community Hosp Intern Med Perspect     Publication Date:  2013  
Date Detail:
Created Date:  2013-07-24     Completed Date:  2013-07-24     Revised Date:  2013-07-26    
Medline Journal Info:
Nlm Unique ID:  101601396     Medline TA:  J Community Hosp Intern Med Perspect     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  -     Citation Subset:  -    
Department of Medicine, Medstar Union Memorial Hospital, Baltimore, MD, USA.
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