Critical takotsubo cardiomyopathy complicated by ventricular septal perforation

Intern Med. 2015;54(1):37-41. doi: 10.2169/internalmedicine.54.3475. Epub 2015 Jan 1.

Abstract

An 81-year-old woman was admitted with chest pain. An electrocardiogram demonstrated ST segment elevation in leads II, III and aVF, and echocardiography revealed left ventricular apical asynergy with a left-to-right ventricular shunt. Meanwhile, emergent coronary angiography showed no significant coronary artery stenosis, whereas left ventriculography indicated apical ballooning and a left-to-right ventricular shunt. We therefore diagnosed the patient with Takotsubo cardiomyopathy complicated by ventricular septal perforation and cardiogenic shock. An electrocardiogram disclosed a prolonged QT interval over time, and the patient became hemodynamically stable under treatment with inotropes; however, she suddenly developed fatal ventricular fibrillation three days after hospitalization. Takotsubo cardiomyopathy complicated by ventricular septal perforation is a critical condition that requires careful monitoring.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Echocardiography
  • Electrocardiography
  • Fatal Outcome
  • Female
  • Humans
  • Shock, Cardiogenic / diagnosis*
  • Shock, Cardiogenic / etiology*
  • Takotsubo Cardiomyopathy / complications*
  • Takotsubo Cardiomyopathy / diagnosis*
  • Ventricular Fibrillation / diagnosis
  • Ventricular Fibrillation / etiology*
  • Ventricular Septal Rupture / diagnosis*
  • Ventricular Septal Rupture / etiology*