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Reversible left ventricular dysfunction "takotsubo" cardiomyopathy associated with pneumothorax
Y J Akashi1, M Sakakibara, F Miyake
1Division of Cardiology, Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki, Japan. johnny@marianna-u.ac.jp
Heart (British Cardiac Society)
|January 18, 2002
Summary
Pneumothorax, a collapsed lung, can cause temporary heart muscle dysfunction. This case shows left ventricular dysfunction resolving spontaneously in an elderly patient with pneumothorax, suggesting catecholamine imbalance.
Area of Science:
- Cardiology
- Pulmonology
- Critical Care Medicine
Background:
- Pneumothorax is a condition characterized by air in the pleural space, leading to lung collapse.
- Cardiac complications can arise from severe respiratory distress and physiological stress.
Observation:
- An 83-year-old female presented with chest pain and dyspnea, diagnosed with left lung pneumothorax.
- Coronary angiography revealed normal coronary arteries.
- Left ventriculography demonstrated apical akinesis and basal hyperkinesis, indicating left ventricular dysfunction.
Findings:
- The observed left ventricular dysfunction, characterized by asynergy, showed significant improvement within 18 days.
- This improvement occurred spontaneously without specific cardiac treatment.
- The findings suggest a potential link between pneumothorax and transient myocardial dysfunction.
Implications:
- Altered catecholamine dynamics secondary to pneumothorax may induce reversible left ventricular dysfunction.
- This case highlights the importance of considering cardiac effects in patients with pneumothorax.
- Further research into the neuro-hormonal mechanisms linking pulmonary and cardiac events is warranted.