Document Detail

The causality quandary in a patient with stroke, takotsubo syndrome and severe coronary artery disease.
MedLine Citation:
PMID:  20935571     Owner:  NLM     Status:  Publisher    
Takotsubo-like left ventricular dysfunction syndrome (TLVDS) and acute coronary syndrome have almost always the same clinical presentation and ECG findings. Both diseases may become a potential cardioembolic source to the cerebrovascular system. Stroke has been linked to TLVDS either as the trigger or as a complication. We report on a 67-year-old female patient who presented with an acute ischemic stroke confirmed by computed tomographic scan of the brain. She also had electrocardiographic features and laboratory findings suggestive of both acute myocardial infarction (AMI) and TLVDS. Coronary angiography revealed severe coronary artery stenoses but the coronary lesions did not have any of the features suggestive of an acute pathology. Echocardiography and left ventriculography showed a striking apical ballooning of the left ventricle, which resolved completely within 1 week, a clinical picture and course typical for TLVDS. There were no signs of left ventricular thrombus. A few burning questions arose from this case: what was the acute cardiac disease - TLVDS or AMI? Which disease came first - the stroke or the acute cardiac illness? An intricate cause-effect relationship is discussed; and finally, does an obstructive coronary artery disease rule out TLVDS?
Shams Y-Hassan; Reidar Winter; Loghman Henareh
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-10-7
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  -     ISSN:  1558-2035     ISO Abbreviation:  -     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Cardiology, Karolinska Institute at Karolinska University Hospital, Stockholm, Sweden.
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