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Takutsubo cardiomyopathy associated with jet-lag syndrome in a Taiwanese elderly woman –a case report and literature review.

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Takotsubo cardiomyopathy associated with jet-lag

syndrome in a Taiwanese elderly woman--A case

report and literatures review

黃群耀

Chiou CS;Chang NC;Shih CM;Huang CY;Lin MS

摘要

Abstract

Takotsubo cardiomyopathy (CM) is still very rare in Taiwan. A 74-year-old

Taiwanese woman came back from abroad for one week and suffered from a persisting and severe jet lag with sleep disturbance. She had a cold and experienced exacerbated bronchial asthma 3 days before the attack. She presented with sudden onset of chest pain after drinking 3 cups of coffee and taking a sauna for more than one hour. Upon

admission, electrocardiogram (ECG) showed ST-segment elevation in leads II, III aVF, and V3-6 while cardiac enzymes reported minimal elevation. Echocardiogram showed apical ballooning and basal hyperkinesias of the left ventricle (LV) in systole. Coronary angiogram on the second day read normal when ST-segment continued to elevate with ongoing chest pain. Negative T wave developed 3 days later. The ECG abnormality and LV dysfunction completely disappeared 6 months later. We diagnosed the case as Takotsubo CM. The activated myocardial adrenergic nervous system stimulated by acute and marked stress in this patient with more adrenergic innervations distributed in apex of LV might be the trigger for this novel cardiac syndrome..

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