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Ampulla cardiomyopathy ('Takotusbo' cardiomyopathy)--reversible left ventricular dysfunction: with ST segment
S Kawai1, H Suzuki, H Yamaguchi
1Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan. chyabo@med.juntendo.ac.jp
Japanese Circulation Journal
|March 15, 2000
Summary
This study investigated reversible left ventricular ampulla-like ventriculograms in elderly patients. Findings suggest focal myocardial damage, not stunned myocardium, despite normal coronary arteriograms during ST elevation.
Area of Science:
- Cardiology
- Pathology
- Medical Imaging
Background:
- Reversible left ventricular ampulla-like ventriculograms present a diagnostic challenge.
- Distinguishing this condition from stunned myocardium is crucial for appropriate patient management.
Purpose of the Study:
- To elucidate the clinicopathologic findings associated with reversible left ventricular ampulla-like ventriculograms.
- To differentiate this entity from stunned myocardium based on diagnostic criteria.
Main Methods:
- Analysis of clinicopathologic findings in nine patients (8 elderly women, 1 middle-aged man).
- Coronary arteriography and electrocardiogram (ECG) evaluation, including provocation tests for coronary spasm.
- Histopathologic examination of myocardial biopsy specimens.
Main Results:
- All patients exhibited normal coronary arteriograms, even with ST elevation on ECG.
- Coronary spasm was confirmed in only 2 of 7 patients undergoing provocation tests.
- Myocardial biopsy revealed focal myocyte injury, indicating myocardial damage.
Conclusions:
- The observed clinicopathologic findings are inconsistent with the concept of stunned myocardium.
- The presence of myocardial lesions strongly suggests focal and disseminated myocardial damage occurred.