Myocardial contrast echocardiography in the diagnosis of postoperative takotsubo myocardiopathy: case report and literature review
Abstract Background Takotsubo cardiomyopathy (TCM) is a brief ventricular dysfunction that usually occurs after emotional or physical stress. Here, we report a patient who underwent cardiac surgery and then developed TCM during the postoperative period. Case presentation A 51-year-old woman was admi...
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12872-018-0985-z |
| _version_ | 1818411029032337408 |
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| author | Jia-Hui Zeng Wei Li Feng-Juan Yao Dong-Hong Liu Cui-Ling Li Yan-Qiu Liu Rui Fan Min Ye Hong Lin |
| author_facet | Jia-Hui Zeng Wei Li Feng-Juan Yao Dong-Hong Liu Cui-Ling Li Yan-Qiu Liu Rui Fan Min Ye Hong Lin |
| author_sort | Jia-Hui Zeng |
| collection | DOAJ |
| description | Abstract Background Takotsubo cardiomyopathy (TCM) is a brief ventricular dysfunction that usually occurs after emotional or physical stress. Here, we report a patient who underwent cardiac surgery and then developed TCM during the postoperative period. Case presentation A 51-year-old woman was admitted to our hospital complaining of chest tightness, palpitations and dyspnoea after activity. An echocardiogram performed by our hospital showed rheumatic heart disease (severe mitral stenosis and regurgitation) with normal cardiac function and wall motion. After mitral valve replacement, this patient developed heart failure with low blood pressure and tachycardia. Urgent bedside echocardiography demonstrated akinesis in the middle and apical segments of the left ventricle and a depressed ejection fraction (EF) of 36%. Myocardial contrast echocardiography (MCE) showed similar enhancement intensity in the basal, middle and apical segments. Quantitative analysis showed approximately equivalent maximum intensity in these regions. The diagnosis was considered TCM instead of myocardial infarction. Then, an intra-aortic balloon pump was inserted to maintain effective circulation and reduce the postcardiac load. Given ventilation therapy, postoperative anticoagulation therapy and anti-infection treatment, the patient recovered quickly. In the follow-up examination, the patient remained asymptomatic and showed normalization of ventricular wall motion in the apical segment. Conclusion This report presents a case of TCM in which MCE was used to demonstrate intact microvascular perfusion despite apical akinesis. This report might support the use of MCE as a substitute for invasive coronary angiography. |
| first_indexed | 2024-12-14T10:24:55Z |
| format | Article |
| id | doaj.art-a6dfea1fd54848db99aae04d0a0ade77 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-14T10:24:55Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-a6dfea1fd54848db99aae04d0a0ade772022-12-21T23:06:22ZengBMCBMC Cardiovascular Disorders1471-22612019-01-011911510.1186/s12872-018-0985-zMyocardial contrast echocardiography in the diagnosis of postoperative takotsubo myocardiopathy: case report and literature reviewJia-Hui Zeng0Wei Li1Feng-Juan Yao2Dong-Hong Liu3Cui-Ling Li4Yan-Qiu Liu5Rui Fan6Min Ye7Hong Lin8Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen UniversityAbstract Background Takotsubo cardiomyopathy (TCM) is a brief ventricular dysfunction that usually occurs after emotional or physical stress. Here, we report a patient who underwent cardiac surgery and then developed TCM during the postoperative period. Case presentation A 51-year-old woman was admitted to our hospital complaining of chest tightness, palpitations and dyspnoea after activity. An echocardiogram performed by our hospital showed rheumatic heart disease (severe mitral stenosis and regurgitation) with normal cardiac function and wall motion. After mitral valve replacement, this patient developed heart failure with low blood pressure and tachycardia. Urgent bedside echocardiography demonstrated akinesis in the middle and apical segments of the left ventricle and a depressed ejection fraction (EF) of 36%. Myocardial contrast echocardiography (MCE) showed similar enhancement intensity in the basal, middle and apical segments. Quantitative analysis showed approximately equivalent maximum intensity in these regions. The diagnosis was considered TCM instead of myocardial infarction. Then, an intra-aortic balloon pump was inserted to maintain effective circulation and reduce the postcardiac load. Given ventilation therapy, postoperative anticoagulation therapy and anti-infection treatment, the patient recovered quickly. In the follow-up examination, the patient remained asymptomatic and showed normalization of ventricular wall motion in the apical segment. Conclusion This report presents a case of TCM in which MCE was used to demonstrate intact microvascular perfusion despite apical akinesis. This report might support the use of MCE as a substitute for invasive coronary angiography.http://link.springer.com/article/10.1186/s12872-018-0985-zTakotsubo cardiomyopathyMyocardial contrast echocardiography |
| spellingShingle | Jia-Hui Zeng Wei Li Feng-Juan Yao Dong-Hong Liu Cui-Ling Li Yan-Qiu Liu Rui Fan Min Ye Hong Lin Myocardial contrast echocardiography in the diagnosis of postoperative takotsubo myocardiopathy: case report and literature review BMC Cardiovascular Disorders Takotsubo cardiomyopathy Myocardial contrast echocardiography |
| title | Myocardial contrast echocardiography in the diagnosis of postoperative takotsubo myocardiopathy: case report and literature review |
| title_full | Myocardial contrast echocardiography in the diagnosis of postoperative takotsubo myocardiopathy: case report and literature review |
| title_fullStr | Myocardial contrast echocardiography in the diagnosis of postoperative takotsubo myocardiopathy: case report and literature review |
| title_full_unstemmed | Myocardial contrast echocardiography in the diagnosis of postoperative takotsubo myocardiopathy: case report and literature review |
| title_short | Myocardial contrast echocardiography in the diagnosis of postoperative takotsubo myocardiopathy: case report and literature review |
| title_sort | myocardial contrast echocardiography in the diagnosis of postoperative takotsubo myocardiopathy case report and literature review |
| topic | Takotsubo cardiomyopathy Myocardial contrast echocardiography |
| url | http://link.springer.com/article/10.1186/s12872-018-0985-z |
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