Is It Only Takotsubo Syndrome? Cardiac MRI and a Case of Delayed ST-ElevationNovel Teaching Points
Takotsubo syndrome is a well described clinical phenomenon that often mimics acute coronary syndrome. We present an atypical case of Takotsubo syndrome, characterized by delayed troponin elevation and electrocardiogram changes suggestive of acute coronary syndrome, but a normal coronary angiogram. W...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-11-01
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| Series: | CJC Open |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589790X20301177 |
| _version_ | 1819100216736874496 |
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| author | Anthony R. Sandre, MSc, MD Darryl P. Leong, MBBS, MPH, MBiostat, PhD David Landry, MD, FRCPC Leslie J. Martin, MHPE, MD, FRCPC |
| author_facet | Anthony R. Sandre, MSc, MD Darryl P. Leong, MBBS, MPH, MBiostat, PhD David Landry, MD, FRCPC Leslie J. Martin, MHPE, MD, FRCPC |
| author_sort | Anthony R. Sandre, MSc, MD |
| collection | DOAJ |
| description | Takotsubo syndrome is a well described clinical phenomenon that often mimics acute coronary syndrome. We present an atypical case of Takotsubo syndrome, characterized by delayed troponin elevation and electrocardiogram changes suggestive of acute coronary syndrome, but a normal coronary angiogram. We describe the integration of cardiac magnetic resonance imaging to identify syndrome overlap, and discuss the utilization of diagnostic modalities beyond coronary angiogram if clinical equipoise exists, including B-type natriuretic peptide/troponin ratio, intravascular coronary imaging, and cardiac magnetic resonance imaging. Résumé: Le syndrome de Takotsubo est un phénomène clinique bien connu qui se présente souvent comme un syndrome coronarien aigu. Nous rapportons un cas atypique de syndrome de Takotsubo caractérisé par une élévation tardive du taux de troponine et par un tracé électrocardiographique évoquant un syndrome coronarien aigu, alors que la coronarographie ne révèle aucune anomalie. Nous décrivons comment utiliser l’imagerie par résonance magnétique cardiaque pour évaluer le chevauchement des deux syndromes et nous présentons l’utilisation des outils diagnostiques autres que la coronarographie en cas d’incertitude clinique absolue, notamment le rapport peptide natriurétique de type B/troponine, l’imagerie endocoronaire et l’imagerie par résonance magnétique cardiaque. |
| first_indexed | 2024-12-22T00:59:15Z |
| format | Article |
| id | doaj.art-05a7a7e882134669b2cb91930922369c |
| institution | Directory Open Access Journal |
| issn | 2589-790X |
| language | English |
| last_indexed | 2024-12-22T00:59:15Z |
| publishDate | 2020-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | CJC Open |
| spelling | doaj.art-05a7a7e882134669b2cb91930922369c2022-12-21T18:44:14ZengElsevierCJC Open2589-790X2020-11-0126722725Is It Only Takotsubo Syndrome? Cardiac MRI and a Case of Delayed ST-ElevationNovel Teaching PointsAnthony R. Sandre, MSc, MD0Darryl P. Leong, MBBS, MPH, MBiostat, PhD1David Landry, MD, FRCPC2Leslie J. Martin, MHPE, MD, FRCPC3Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Corresponding author: Dr Anthony R. Sandre, Department of Medicine, McMaster University, Health Sciences Centre, 4V33, 1200 Main St W, Hamilton, Ontario L8N 3Z5, Canada. Tel.: +1-905-521-2100 x76395.Department of Medicine, McMaster University, Hamilton, Ontario, Canada; The Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, CanadaDepartment of Radiology, McMaster University, Hamilton, Ontario, CanadaDepartment of Medicine, McMaster University, Hamilton, Ontario, CanadaTakotsubo syndrome is a well described clinical phenomenon that often mimics acute coronary syndrome. We present an atypical case of Takotsubo syndrome, characterized by delayed troponin elevation and electrocardiogram changes suggestive of acute coronary syndrome, but a normal coronary angiogram. We describe the integration of cardiac magnetic resonance imaging to identify syndrome overlap, and discuss the utilization of diagnostic modalities beyond coronary angiogram if clinical equipoise exists, including B-type natriuretic peptide/troponin ratio, intravascular coronary imaging, and cardiac magnetic resonance imaging. Résumé: Le syndrome de Takotsubo est un phénomène clinique bien connu qui se présente souvent comme un syndrome coronarien aigu. Nous rapportons un cas atypique de syndrome de Takotsubo caractérisé par une élévation tardive du taux de troponine et par un tracé électrocardiographique évoquant un syndrome coronarien aigu, alors que la coronarographie ne révèle aucune anomalie. Nous décrivons comment utiliser l’imagerie par résonance magnétique cardiaque pour évaluer le chevauchement des deux syndromes et nous présentons l’utilisation des outils diagnostiques autres que la coronarographie en cas d’incertitude clinique absolue, notamment le rapport peptide natriurétique de type B/troponine, l’imagerie endocoronaire et l’imagerie par résonance magnétique cardiaque.http://www.sciencedirect.com/science/article/pii/S2589790X20301177 |
| spellingShingle | Anthony R. Sandre, MSc, MD Darryl P. Leong, MBBS, MPH, MBiostat, PhD David Landry, MD, FRCPC Leslie J. Martin, MHPE, MD, FRCPC Is It Only Takotsubo Syndrome? Cardiac MRI and a Case of Delayed ST-ElevationNovel Teaching Points CJC Open |
| title | Is It Only Takotsubo Syndrome? Cardiac MRI and a Case of Delayed ST-ElevationNovel Teaching Points |
| title_full | Is It Only Takotsubo Syndrome? Cardiac MRI and a Case of Delayed ST-ElevationNovel Teaching Points |
| title_fullStr | Is It Only Takotsubo Syndrome? Cardiac MRI and a Case of Delayed ST-ElevationNovel Teaching Points |
| title_full_unstemmed | Is It Only Takotsubo Syndrome? Cardiac MRI and a Case of Delayed ST-ElevationNovel Teaching Points |
| title_short | Is It Only Takotsubo Syndrome? Cardiac MRI and a Case of Delayed ST-ElevationNovel Teaching Points |
| title_sort | is it only takotsubo syndrome cardiac mri and a case of delayed st elevationnovel teaching points |
| url | http://www.sciencedirect.com/science/article/pii/S2589790X20301177 |
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