Transient left ventricular apical ballooning developing after the Central Niigata Prefecture Earthquake: two case
Minoru Tagawa1, Yuichi Nakamura, Maki Ishiguro
1Department of Cardiology, Nagaoka Chuo General Hospital, Niigata. m-tagawa@dc5.so-net.ne.jp
Journal of Cardiology
|September 30, 2006
Summary
Severe emotional stress from earthquakes can cause takotsubo cardiomyopathy, also known as transient left ventricular apical ballooning. This condition affects heart muscle function, leading to chest pain and characteristic ECG changes.
Area of Science:
- Cardiology
- Emergency Medicine
- Psychosomatic Medicine
Background:
- Takotsubo cardiomyopathy (TTC) is a stress-induced cardiac dysfunction.
- Natural disasters like earthquakes can trigger significant emotional distress.
Observation:
- Two patients experienced chest pain immediately following the 2004 Central Niigata Prefecture Earthquake.
- Electrocardiography (ECG) revealed ST segment abnormalities and inverted T waves in both patients.
- Transthoracic echocardiography showed apical hypokinesis, characteristic of TTC.
Findings:
- Coronary angiography excluded obstructive coronary artery disease and spasms.
- Myocardial sympathetic innervation imaging (MIBG and 201Tl SPECT) demonstrated apical MIBG uptake defects and increased washout.
- These findings indicate stress-induced cardiac dysfunction consistent with takotsubo cardiomyopathy.
Implications:
- Earthquakes and intense emotional stress are potential triggers for takotsubo cardiomyopathy.
- Early recognition and diagnosis are crucial for managing stress-induced cardiac events.
- Understanding the link between emotional stress and cardiac dysfunction aids in patient care and research.
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