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Cardiac sympathetic activity in stress-induced (Takotsubo) cardiomyopathy

Nature Reviews Cardiology volume 6, pages 430–434 (2009)Cite this article

Abstract

Background. A 54-year-old postmenopausal woman presented with retrosternal chest pressure, nausea, and vomiting of 4 h duration. Her medical history included hypertension (treated with metoprolol and ramipril), hyperlipidemia (treated with atorvastatin), and depression (treated with fluoxetine). A few hours before symptom onset, she had witnessed an accident in which her sister sustained serious injuries. The patient was visiting her sister—who was in critical condition in the hospital—when the symptoms began.

Investigations. Physical examination, chest radiography, laboratory testing, electrocardiography, coronary angiography, and PET with 11C hydroxyephedrine.

Diagnosis. Stress-induced (Takotsubo) cardiomyopathy (apical ballooning syndrome).

Management. The patient was monitored with cardiac telemetry. Metoprolol and ramipril were continued.

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Figure 1: Left ventriculogram.
Figure 2: Short-axis images in the patient at 2 days and 6 weeks after presentation with stress-induced cardiomyopathy.
Figure 3: Physiological parameters calculated from the patient's PET imaging studies.

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Acknowledgements

This study was supported by the Mayo Award for Research in Cardiology. The authors thank the Mayo Cyclotron personnel, Mayo PET technologists, and Teresa Decklever and Lennon Jordan for PET data analysis. Written consent for publication was obtained from the patient.

Charles P. Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the Medscape-accredited continuing medical education activity associated with this article.

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Authors and Affiliations

  1. Mayo Clinic, Rochester, MN, USA

    Abhiram Prasad, Malini Madhavan & Panithaya Chareonthaitawee

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  1. Abhiram Prasad
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  2. Malini Madhavan
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  3. Panithaya Chareonthaitawee
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Correspondence to Panithaya Chareonthaitawee.

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Prasad, A., Madhavan, M. & Chareonthaitawee, P. Cardiac sympathetic activity in stress-induced (Takotsubo) cardiomyopathy. Nat Rev Cardiol 6, 430–434 (2009). https://doi.org/10.1038/nrcardio.2009.51

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