Nevado PJ, Fernández QM, Jiménez DJ, Benezet MJ, Campos PA

Language: Spanish
References: 9
Page: 40-43
PDF size: 122.44 Kb.

ABSTRACT

The Tako-Tsubo transient left ventricular apical ballooning was born as a clinical profile in the year 2001¹_(IBM1). This syndrome occurs mainly in women older than 60 years and it is frequently preceded by a physical or emotional stress. Its presentation simulates a myocardial infarction, although with some differences: the pain is not always typical, and its intensity is moderate. The electrocardiogram reveals an elevation of ST in the anterior face in 90% of the cases; from the second day on, negative T waves in V2 through V6 leads are present, along with prolongation of the QTc interval. Enzymes are poorly elevated as expected from the electrical alterations. The alteration that defines the syndrome is the hypokinesis or akinesis of the apical segments with hyperkinesis of the basal ones. The main uncertainty of the Tako-Tsubo syndrome is its pathogenesis, its elucidation will provide advances in the practical handling of this syndrome²_(IBM2). We present the clinical case of a patient with this syndrome and a review of the existing medical literature on the possible association with a predisposing coronary anatomy in the apical segment.

REFERENCES

1. Tsuchihashi K, Ueshima K, Uchida, Oh-mura N, Kimura K, Owa M, et al: Transient left ventricular apical ballooning without coronary artery stenosis: a novel heart syndrome mimicking acute myocardial infarction. J Am Coll Cardiol 2001; 38: 11-8.

2. Segovia J, Peraira R: Disfunción apical transitoria: un síndrome en transición hacia la edad adulta. Rev Esp Cardiol 2004; 57(3): 194-197.

3. Gaspar J, Gómez Cruz R: Síndrome Tako Tsubo (Discinesia antero-apical transitoria): Primer caso descrito en América Latina y revisión de la literatura. Arch Cardiol de Mex 2004; 74(3): 205-214.

4. Peraira M Jr, Segovia CJ, Oteo DJF, Ortiz OP, Fuentes MR, Martin JV: Síndrome de discinesia apical transitoria con una complicación inhabitual. Rev Esp Cardiol 2002; 55: 1328-32.

5. Barriales VR, Bilbao QR, Iglesias RE, Bayon MN, Mantilla GR, Penas LM: Síndrome de discinesia apical transitoria sin lesiones coronarias: importancia del gradiente intraventricular. Rev Esp Cardiol 2004; 57: 85-8.

6. Borja I, Navarro F, Farré J, Marcos-Alberca P, Orejas M, Rábago R, et al: Asociación del síndrome de Tako-Tsubo con la arteria coronaria descendente anterior con extensa distribución por el segmento diafragmático. Rev Esp Cardiol 2004; 57(3): 209-216.

7. Kurisu S, Sato H, Kawagoe T, Ishihara M, Shimatani Y, Nishioka K, et al: Tako-Tsubo-like left ventricular dysfunction with ST –segment elevation: a novel cardiac syndrome mimicking acute myocardial infarction. Am Heart J 2002; 143: 448-55.

8. Desmet WJR, Adriaenssens BFM, Dens JAY: Apical ballooning on the left ventricle: first series in white patients. Heart 2003; 89: 1027-31.

9. Gallego PJC, Lafuente GC, Domínguez RP, Cháfer RM, Fuentes MR, Aguilera SM: Disfunción ventricular izquierda tras estrés emocional. Rev Esp Cardiol 2004; 57(11): 1124-1127.