Abstract
The tako-tsubo syndrome, or transient left ventricular apical ballooning, has been widely described in Japan as a cardiomyopathy which resembles acute myocardial infarction on presentation, but characterized by a normal coronary tree and a favorable outcome. Conversely few series have been described in Europe and etiology and mechanism are still unknown. We describe the case of a 74-year-old Italian woman with tako-tsubo cardiomyopathy, one of the first Italian cases reported to our knowledge. In the acute phase, echocardiography and ventriculography showed the typical mid-apical systolic left ventricular dysfunction, with an angiographically normal coronary tree. A few days after, technetium-99m single-photon emission computed tomography disclosed a large mid-apical perfusion defect and dobutamine stress echocardiography showed a typical "biphasic" response. Three months later, all of these tests normalized with normal left ventricular function. In conclusion, the results of functional tests, during the acute and subacute phases, suggest that, in the absence of evident coronary spasm, a transitory reduction of the coronary reserve played a role in the pathogenesis. In the absence of epicardial coronary obstruction this could be due to a transient microcircle dysfunction, and may be attributed to a spasm followed by impaired vasodilation capability.
| Original language | English |
|---|---|
| Pages (from-to) | 933-938 |
| Number of pages | 6 |
| Journal | Italian Heart Journal |
| Volume | 6 |
| Issue number | 11 |
| Publication status | Published - Nov 2005 |
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Keywords
- Coronary microcirculation
- Echocardiography
- Ischemic heart disease
- Myocardial ischemia
- Myocardial scintigraphy
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Tako-tsubo : A transitory impairment of microcirculation? A case report. / Malafronte, Cristina; Farina, Andrea; Tempesta, Angela; Lobiati, Elisabetta; Galbiati, Roberto; Cantù, Edoardo; Piatti, Luigi; Florimonte, Luigia; Maffioli, Lorenzo; Achilli, Felice.
In: Italian Heart Journal, Vol. 6, No. 11, 11.2005, p. 933-938.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Tako-tsubo
T2 - A transitory impairment of microcirculation? A case report
AU - Malafronte, Cristina
AU - Farina, Andrea
AU - Tempesta, Angela
AU - Lobiati, Elisabetta
AU - Galbiati, Roberto
AU - Cantù, Edoardo
AU - Piatti, Luigi
AU - Florimonte, Luigia
AU - Maffioli, Lorenzo
AU - Achilli, Felice
PY - 2005/11
Y1 - 2005/11
N2 - The tako-tsubo syndrome, or transient left ventricular apical ballooning, has been widely described in Japan as a cardiomyopathy which resembles acute myocardial infarction on presentation, but characterized by a normal coronary tree and a favorable outcome. Conversely few series have been described in Europe and etiology and mechanism are still unknown. We describe the case of a 74-year-old Italian woman with tako-tsubo cardiomyopathy, one of the first Italian cases reported to our knowledge. In the acute phase, echocardiography and ventriculography showed the typical mid-apical systolic left ventricular dysfunction, with an angiographically normal coronary tree. A few days after, technetium-99m single-photon emission computed tomography disclosed a large mid-apical perfusion defect and dobutamine stress echocardiography showed a typical "biphasic" response. Three months later, all of these tests normalized with normal left ventricular function. In conclusion, the results of functional tests, during the acute and subacute phases, suggest that, in the absence of evident coronary spasm, a transitory reduction of the coronary reserve played a role in the pathogenesis. In the absence of epicardial coronary obstruction this could be due to a transient microcircle dysfunction, and may be attributed to a spasm followed by impaired vasodilation capability.
AB - The tako-tsubo syndrome, or transient left ventricular apical ballooning, has been widely described in Japan as a cardiomyopathy which resembles acute myocardial infarction on presentation, but characterized by a normal coronary tree and a favorable outcome. Conversely few series have been described in Europe and etiology and mechanism are still unknown. We describe the case of a 74-year-old Italian woman with tako-tsubo cardiomyopathy, one of the first Italian cases reported to our knowledge. In the acute phase, echocardiography and ventriculography showed the typical mid-apical systolic left ventricular dysfunction, with an angiographically normal coronary tree. A few days after, technetium-99m single-photon emission computed tomography disclosed a large mid-apical perfusion defect and dobutamine stress echocardiography showed a typical "biphasic" response. Three months later, all of these tests normalized with normal left ventricular function. In conclusion, the results of functional tests, during the acute and subacute phases, suggest that, in the absence of evident coronary spasm, a transitory reduction of the coronary reserve played a role in the pathogenesis. In the absence of epicardial coronary obstruction this could be due to a transient microcircle dysfunction, and may be attributed to a spasm followed by impaired vasodilation capability.
KW - Coronary microcirculation
KW - Echocardiography
KW - Ischemic heart disease
KW - Myocardial ischemia
KW - Myocardial scintigraphy
UR - http://www.scopus.com/inward/record.url?scp=33644810677&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33644810677&partnerID=8YFLogxK
M3 - Article
C2 - 16320933
AN - SCOPUS:33644810677
VL - 6
SP - 933
EP - 938
JO - Italian Heart Journal
JF - Italian Heart Journal
SN - 1129-471X
IS - 11
ER -