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Reversible ventricular dysfunction (takotsubo cardiomyopathy) following polymorphic ventricular tachycardia
Yoshihiro J Akashi1, Kiyoshi Nakazawa, Keisuke Kida
1Division of Cardiology, Department of Internal Medicine, St Marianna University School of Medicine, Kawasaki, Japan. johnny@marianna-u.ac.jp
The Canadian Journal of Cardiology
|April 22, 2003
Summary
A rare case of takotsubo cardiomyopathy developed after polymorphic ventricular tachycardia. The ventricular dysfunction resolved within 14 days, suggesting a catecholamine-mediated mechanism.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiomyopathy
Background:
- Takotsubo cardiomyopathy (TTC) is typically associated with emotional or physical stress.
- Ventricular arrhythmias are not commonly recognized triggers for TTC.
Observation:
- A 67-year-old female experienced recurrent syncope and a 90-second episode of polymorphic ventricular tachycardia.
- Following the tachycardia, she developed left ventricular apical akinesis and basal hyperkinesis, consistent with TTC.
- Coronary angiography and electrophysiological studies ruled out coronary artery disease and inducible arrhythmias.
Findings:
- ECG showed deeply inverted T waves in anterior and lateral leads, persisting for over a week.
- Left ventricular dysfunction resolved spontaneously within 14 days.
- No specific treatment was required for hemodynamic support.
Implications:
- This case highlights a potential, albeit uncommon, link between ventricular arrhythmias and takotsubo cardiomyopathy.
- Altered catecholamine dynamics during sustained tachycardia and syncope may precipitate TTC.
- Further research is needed to elucidate the precise mechanisms linking arrhythmias to TTC.