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Stress cardiomyopathy with an "inverse" takotsubo pattern in a patient with acute aneurysmal subarachnoid hemorrhage.

Publication ,  Journal Article
Waller, CJ; Vandenberg, B; Hasan, D; Kumar, AB
Published in: Echocardiography
September 2013

BACKGROUND: Subarachnoid hemorrhage (SAH) induced myocardial dysfunction (often labeled neurogenic stunned myocardium) encompasses a spectrum of clinical presentations ranging from an isolated elevation of cardiac enzymes to cardiogenic shock. OBJECTIVE: We describe a case of stress cardiomyopathy in a patient following acute aneurysmal subarachnoid hemorrhage that showed an "inverse" or reverse takotsubo pattern on echocardiography. CASE REPORT: The patient was a 46-year-old female who presented with acute cardiogenic shock following acute subarachnoid hemorrhage necessitating aggressive cardiorespiratory in the ICU. Her admission echo showed a depressed left ventricular ejection fraction of 25%. The basal 2/3 of the left ventricle (LV) was severely hypokinetic and the apical 1/3 of the LV was hypercontractile, i.e. the reverse or inverse takotsubo pattern of regional wall motion abnormality. With ongoing aggressive support her cardiovascular function steadily improved and on day 6 her follow up echo showed LV ejection fraction increased to 60-65% with resolution of the previous regional wall motion abnormality. The patient was discharged to a neuro-rehabilitation facility on day 16. SUMMARY: The "inverse" or "reverse" takotsubo pattern of regional wall motion abnormalities, i.e. with preserved apical LV contractility and hypokinesis of the basal walls of the LV is more common in patients following acute SAH.

Duke Scholars

Published In

Echocardiography

DOI

EISSN

1540-8175

Publication Date

September 2013

Volume

30

Issue

8

Start / End Page

E224 / E226

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Takotsubo Cardiomyopathy
  • Subarachnoid Hemorrhage
  • Middle Aged
  • Humans
  • Female
  • Echocardiography
  • Diagnosis, Differential
  • Cardiovascular System & Hematology
  • Acute Disease
 

Citation

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Waller, C. J., Vandenberg, B., Hasan, D., & Kumar, A. B. (2013). Stress cardiomyopathy with an "inverse" takotsubo pattern in a patient with acute aneurysmal subarachnoid hemorrhage. Echocardiography, 30(8), E224–E226. https://doi.org/10.1111/echo.12266
Waller, Christine J., Byron Vandenberg, David Hasan, and Avinash B. Kumar. “Stress cardiomyopathy with an "inverse" takotsubo pattern in a patient with acute aneurysmal subarachnoid hemorrhage.Echocardiography 30, no. 8 (September 2013): E224–26. https://doi.org/10.1111/echo.12266.
Waller CJ, Vandenberg B, Hasan D, Kumar AB. Stress cardiomyopathy with an "inverse" takotsubo pattern in a patient with acute aneurysmal subarachnoid hemorrhage. Echocardiography. 2013 Sep;30(8):E224–6.
Waller, Christine J., et al. “Stress cardiomyopathy with an "inverse" takotsubo pattern in a patient with acute aneurysmal subarachnoid hemorrhage.Echocardiography, vol. 30, no. 8, Sept. 2013, pp. E224–26. Pubmed, doi:10.1111/echo.12266.
Waller CJ, Vandenberg B, Hasan D, Kumar AB. Stress cardiomyopathy with an "inverse" takotsubo pattern in a patient with acute aneurysmal subarachnoid hemorrhage. Echocardiography. 2013 Sep;30(8):E224–E226.
Journal cover image

Published In

Echocardiography

DOI

EISSN

1540-8175

Publication Date

September 2013

Volume

30

Issue

8

Start / End Page

E224 / E226

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Takotsubo Cardiomyopathy
  • Subarachnoid Hemorrhage
  • Middle Aged
  • Humans
  • Female
  • Echocardiography
  • Diagnosis, Differential
  • Cardiovascular System & Hematology
  • Acute Disease