View source for Stress cardiomyopathy - Takotsubo

{{Case
|Title = Takotsubo
|CasePresentation = Mimicking myocardial infarction by a stress cardiomyopathy

An 81-year-old woman with no cardiac history presented with acute chestpain which radiated to the left arm. The blood pressure was 140/80 mmHg and a heart rate of110/min. Physical examination revealed no abnormalities. The electrocardiogram was compatible with acute anterior myocardial infarction. (A) Immediate coronary angiography showed normal coronary arteries (B and C). A left ventricular (LV) angiogram revealed a Tako-tsubo-like cardiomyopathy, recognized by a hypercontractile base and a bulging out of the LV-apex at systole (D), which normalizes at diastole (E). This typical LV-angiogram resembles a local octopus trap in Japan , where this cardiomyopathy was first described. Although clinical presentation can be quite severe, prognosis is usually good with complete LV recovery. It occurs commonly in post-menopausal woman, usually  provoked after extreme emotional stress. In a second interview, the patient told she had a severe emotional experience at a parking lot that morning, after which she developed chestpain.

|Courtesy = Courtesy of M. Meuwissen, MD, PhD, AMC, The Netherlands

|filepointer1=[[Image:MM0100.jpg|300px]]
|file_name1=
|descriptionfile1=Figure A: Electrocardiogram

|filepointer2=<flash>file=MM0099.swf|quality=best|align=center|width=300|height=300</flash>
|file_name2=MM0099
|descriptionfile2=Movie B: Angiography RCA

|filepointer3=<flash>file=MM0097.swf|quality=best|align=center|width=300|height=300</flash>
|file_name3=MM0097
|descriptionfile3=Movie C: Angiography LCA

|filepointer4=<flash>file=MM0098.swf|quality=best|align=center|width=300|height=300</flash>
|file_name4=MM0098
|descriptionfile4=Movie D: Left ventricular angiography


|filepointer5=[[Image:MM0105.jpg|300px]]
|file_name5=
|descriptionfile5=Image E: Still frames of left ventricular angiography at end systole and end diastole

}}