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Updated: Jul 14, 2026

Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Intracranial bleeding mimicking an extensive acute myocardial infarction with reversible apical ballooning and
Antonio D'Aloia1, Enrico Vizzardi, Pompilio Faggiano
1Unità Operativa di Cardiologia, Spedali Civili, Brescia, Italy.
Insights
Tako-tsubo cardiomyopathy, a reversible heart condition, can mimic heart attacks. This case highlights its link to intracranial bleeding, emphasizing the need for careful diagnosis.
Area of Science:
- Cardiology
- Neurology
Background:
- Tako-tsubo cardiomyopathy, or stress-induced cardiomyopathy, presents symptoms similar to acute myocardial infarction.
- It is characterized by transient left ventricular apical ballooning and dysfunction.
Observation:
- A 69-year-old woman presented with chest pain and ECG changes suggestive of myocardial infarction.
- Echocardiography revealed significant left ventricular dysfunction.
Findings:
- Coronary angiography excluded coronary artery disease, thrombi, or spasm.
- Brain imaging identified a subarachnoid hemorrhage due to a ruptured vertebral artery aneurysm.
Implications:
- This case underscores the importance of considering reversible cardiomyopathy in patients with intracranial bleeding.
- Prompt diagnosis and management are crucial for differentiating Tako-tsubo cardiomyopathy from acute coronary syndromes.
Abstract:
A novel syndrome with transient asynergy of the apical segments of the left ventricle, also known as tako-tsubo cardiomyopathy, has been recently described and presents characteristics and effects similar to acute myocardial infarction. We report the case of a 69-year-old woman presenting with chest pain typical of myocardial ischemia, electrocardiographic abnormalities typical of antero-lateral transmural myocardial infarction, and unstable clinical and hemodynamic condition. Trans-thoracic echocardiography showed a left ventricular dysfunction with a markedly decreased ejection fraction. The patient received heparin and abciximab bolus but coronary angiography demonstrated the absence of coronary stenoses, thrombi, and coronary spasm. Due to impaired neurological conditions the patient underwent brain tomography that showed subarachnoid haemorrhage secondary to a right vertebral artery aneurysm rupture. The possible occurrence of a reversible cardiomyopathy mimicking an acute coronary syndrome in presence of intracranial bleeding should be always considered.
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