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Ventricular septal perforation in a patient with takotsubo cardiomyopathy

Kenya Sakai1, Hiroyuki Ochiai, Norihiko Katayama

  • 1Department of Internal Medicine, Kure City Medical Association Hospital, Japan.

Circulation Journal : Official Journal of the Japanese Circulation Society
|February 26, 2005
PubMed

Insights

A rare case of takotsubo cardiomyopathy complicated by ventricular septal perforation occurred in an 84-year-old woman. Despite presenting with acute myocardial infarction symptoms, coronary angiography showed no stenosis, leading to a fatal cardiogenic shock outcome.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine

Background:

  • Takotsubo cardiomyopathy, often triggered by emotional or physical stress, mimics acute myocardial infarction.
  • Ventricular septal perforation is a rare but severe complication of myocardial infarction.

Observation:

  • An 84-year-old female presented with anorexia and symptoms suggestive of acute myocardial infarction.
  • Initial investigations including cardiac markers, ECG, and echocardiography indicated acute myocardial infarction, prompting emergency cardiac catheterization.

Findings:

  • Coronary angiography revealed no significant coronary artery stenosis.
  • Left ventriculography demonstrated left ventricular apical akinesis and a shunt flow to the right ventricle.
  • The patient was diagnosed with takotsubo cardiomyopathy complicated by ventricular septal perforation.

Implications:

  • This case highlights the critical importance of considering rare complications in stress-induced cardiomyopathy.
  • Accurate diagnosis and timely management are crucial, although outcomes can be poor in cases of ventricular septal perforation.
  • Further research into the mechanisms and management of such rare presentations is warranted.

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