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역위된 문어단지 양 심근병증으로 발현되어 진단된 악성 갈색세포종 1예
장정은,권혁희,이민정,정창희,배성진,김홍규,이우제 대한내분비학회 2012 Endocrinology and metabolism Vol.27 No.1
Takotsubo cardiomyopathy or stress induced cardiomyopathy is characterized by acute transient left ventricular apical ballooning without significant coronary artery disease. The pathophysiology of Takotsubo cardiomyopathy remains unclear, but it has been suggested that the stress related neurohumoral factors, especially catecholamines, play an important role. Recently, several reports have described an inverted Takotsubo cardiomyopathy, which is characterized by the dysfunction of the basal and mid-ventricular segments sparing the apex of the heart. In this report, we present a case of a 50-year-old female with a transient left ventricular dysfunction in an inverted Takotsubo pattern, that later was diagnosed as a malignant pheochromocytoma.
기흉과 관련된 Takotsubo심근병증 이후 발생한 급성 뇌경색
박민규,김선혜,이재혁,조재욱,김대성,박용현,나용준,박경필 대한신경과학회 2011 대한신경과학회지 Vol.29 No.2
Takotsubo cardiomyopathy is a transient condition characterized by acute left ventricular dysfunction without evidence of significant coronary artery obstruction. Takotsubo cardiomyopathy is not an uncommon complication of subarachnoid hemorrhage or acute cerebral infarction, but acute cerebral infarction is a rare thromboembolic complication in patients with Takotsubo cardiomyopathy. We present a patient with acute cerebral infarction following Takotsubo cardiomyopathy associated with pneumothorax.
수술 후 중환자실 치료 중 발생한 Takotsubo 심근병증
손국희,김광택,선경,손호성,송재윤,이성호,정재승,김용현 대한중환자의학회 2009 Acute and Critical Care Vol.24 No.3
`Takotsubo cardiomyopathy` or `stress-induced cardiomyopathy` is a newly described clinical entity that`s characterized by transient left ventricular apical ballooning and left ventricular apical dyskinesis in the absence of any angiographic feature of significant coronary artery disease. The cause of takotsubo cardiomyopathy is unclear, but catecholamines probably play a role in the genesis of takotsubo cardiomyopathy. We report here on two cases of takotsubo cardiomyopathy that occurred during ICU care.
반전된 Takotsubo 형태를 보이는 스트레스성 심근병증 1예
임상우 ( Sang Woo Yim ),천우정 ( Woo Jung Chun ),오주현 ( Ju Hyun Oh ),박용휘 ( Yong Whi Park ),박용환 ( Yong Whan Park ),박건태 ( Geon Tae Park ),송준휘 ( Jun Hwi Song ) 대한내과학회 2009 대한내과학회지 Vol.76 No.6
스트레스성 심근병증은 다양한 육체적 또는 정신적 스트레스 후 발생하는 심장질환 증후군으로 초기 임상양상이 급성 관상동맥 증후군과 유사하지만 양호한 예후를 갖는다. 그러나 기존에 발표된 연구에서는 대부분의 환자에서 심첨부나 중간부 좌심실에서 무운동성을 관찰되었으나 저자들은 심실 기저부의 무운동성이 관찰되는 스트레스성 심근병증증례를 경험하였기에 보고한다. Stress-induced cardiomyopathy, known as Takotsubo cardiomyopathy, is a newly described clinical entity characterized by transient left ventricular apical ballooning and left ventricular apical dyskinesis, with no significant stenosis on the coronary angiogram. We describe a patient who had transient cardiomyopathy with akinesia of the basal portions of the left ventricle and hyperkinesia of the apex. This is the first case of stress-induced cardiomyopathy with an "inverted Takotsubo" contractile pattern triggered by emotional stress in Korea. The cause of stress-induced cardiomyopathy is unclear, but catecholamines probably play a role in this syndrome. This entity could provide clues to the pathophysiology underlying stress-induced cardiomyopathy. (Korean J Med 76:746-751, 2009)
Tacotsubo Cardiomyopathy Secondary to Pyogenic Liver Abscess
( Jeong Ill Suh ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Background: Takotsubo cardiomyopathy, also known as stress cardiomyopathy, is a type of non-ischemic cardiomyopathy in which myocardium suddenly weaken temporarily and is caused by emotional or physical stress such as sepsis, bleeding, asthma, or pheochromocytoma. Several infections have also been shown to precipitate Takotsubo cardiomyopathy. However, few cases have demonstrated the association with liver abscess. Reported herein is a rare case of Takotsubo cardiomyopathy precipitated by the liver abscess. Case: A 73-year-old female was admitted due to fever. She has been without any illness. She was acute ill looking appearance. Initial vital signs were: BP 110/60 mmHg, HR 101 beats/min, RR 20 breaths/min, temperature 38.0℃. Laboratory studies revealed WBC 21,550/㎣, hemoglobin 14.7 g/dL, platelet 101,000/㎣, prothrombin time was 15.8 sec (INR of 1.44). AST/ALT 94/87 IU/L, total bilirubin 0.89 mg/dL, albumin 2.9 g/dL, r-GTP 66 U/L, ALP 139 U/L. Viral markers were HBsAg(-), anti-HBs(+), anti-HBc IgM(-), anti-HAV IgM(-), anti-HCV(-). Initial EKG showed sinus tachycardia. Abdominal CT showed about 5x6cm sized cystic mass like lesion with air bubbles in the liver S8. Percutanenous catheter drainage was performed and antibiotic treatment was started. On 2<sup>nd</sup> day after admission, she developed suddenly worsening of dyspnea followed by blood pressure drop. Follow up EKG revealed myocardial ischemic change of lateral wall. CK 602 U/L, CK-MB 105.4 ng/ml, LDH 613 U/L, Troponin-I 18.8 ng/ml. Transthorasic echocardiography showed diffuse myocardial hyokinesia (ejection fraction 26%). But, coronorary angiogram showed completely normal findings. The cultured pus and blood samples were positive for K. pneumoniae. On the 11th day of hospitalization, her cardiac function was restored and EKG showed normal sinus rhythm. Her liver function recovered completely to normal and follow up abdominal CT showed marked decreased size of liver abscess on 38th day of hospitalization. Conclusions: Tacotsubo cardiomyopathy caused by pyogenic liver abscess is rare. The presentation is vary from asymptomatic to chest pain, shortness of breath, nausea, vomiting, palpitations or fainting. It may also show an EKG change and troponin elevation similar to myocardial infarction. Although stress cardiomyopathy is a reversible condition, but it can be serious and fatal.
이윤주,이한,김경민,이동현,이준홍,최선아,조정희,김종헌,김규식 대한신경과학회 2014 대한신경과학회지 Vol.32 No.3
Takotsubo cardiomyopathy is a reversible cardiac syndrome that occurs subsequently to other medical illnesses such ascerebral hemorrhage, shock, or seizure disorders that are presumed to disturb autonomic regulation. This syndrome ischaracterized by chest pain, dyspnea, and electrocardiographic changes mimicking an acute coronary syndrome. Mildelevation of cardiac enzymes and transient wall-motion abnormalities of apical akinesia can appear. However, takotsubocardiomyopathy following epilepsy is not well recognized. We report two cases of takotsubo-cardiomyopathy-relatedidiopathic status epilepticus presenting with cardiogenic shock.
( Pil Hyung Lee ),( Jae Kwan Song ),( In Keun Park ),( Byung Joo Sun ),( Seung Geun Lee ),( Ji Hye Yim ),( Hyung Oh Choi ) 대한내과학회 2011 The Korean Journal of Internal Medicine Vol.26 No.4
Takotsubo cardiomyopathy (TTC) is an infrequent cardiac syndrome characterized by acute onset chest pain with apical ballooning on echocardiography. It is often triggered by severe emotional or physical stress, and in contrast to acute myocardial infarction (AMI), the regional wall motion abnormality returns to normal within days. Here, we describe a 62-year-old female who presented with acute onset chest pain during treatment for a liver abscess. We presumed a diagnosis of AMI because of ST segment elevation on electrocardiography and elevated cardiac enzyme levels. However, the patient`s coronary arteries were normal on angiography, and apical ballooning was seen on echocardiography. A diagnosis of TTC was made, and the patient was managed with intensive cardiopulmonary support using vasopressors in our hospital`s medical intensive care unit. The patient`s symptoms improved, but persistent severe left ventricular dysfunction was detected on follow-up echocardiography. After 5 weeks, a new apical mural thrombus appeared, and anticoagulation therapy was started. The apical ballooning persisted 3 months later, although the patient`s overall ejection fraction was slightly improved. The apical thrombus was completely resolved without any embolic event. Non-adrenergic inotropics can be recommended in TTC with shock, and clinicians should keep in mind the potential risk of thrombus formation and cardioembolism.
신승남,윤경호,고점석,이상재,유남진,김남호,오석규,정진원 한국심초음파학회 2011 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.19 No.3
Takotsubo cardiomyopathy, also called stress-induced cardiomyopathy, usually occurs in patients with severe emotional or physiologic stress. The prognosis is favorable, and the wall motion abnormlities normalize within weeks. However, stress-induced cardiomyopathy is rarely assosicated with left ventricular thrombus and thromboembolic complications. Here, we report a case of stress-induced cardiomyopathy with left ventricular thrombus that embolized to cause cerebral infarction.
이호성,Se-Whan Lee,Young Kyu Jung,Ung Jeon,박상호,Seung Jin Lee,Won-Yong Sin,Dong-Kyu Jin 대한심장학회 2013 Korean Circulation Journal Vol.43 No.8
The etiology and pathophysiology of takotsubo cardiomyopathy have not yet been fully clarified. We report a case of takotsubo cardio -myopathy associated with severe hypocalcemia secondary to hypoparathyroidism. A 69-year-old woman presented with acute pulmonary edema caused by severe left ventricular dysfunction with apical ballooning compatible with takotsubo cardiomyopathy. Laboratory tests revealed severe hypocalcemia secondary to idiopathic hypoparathyroidism. Coronary angiography showed normal coronary artery func-tion. Her symptoms and signs of heart failure improved dramatically with the correction of hypocalcemia through calcium and calcitriol replacement.
Takotsubo 심근병증과 관상동맥 질환의 동시 발생 1예
박재영 ( Jae Young Park ),김수현 ( Su Hyun Kim ),김철환 ( Cheol Hwan Kim ),최승 ( Seung Choi ),범재원 ( Jae Won Beom ),박건 ( Gun Park ),윤명호 ( Yung Ho Yun ) 대한내과학회 2012 대한내과학회지 Vol.83 No.6
Takotsubo cardiomyopathy is characterized clinically by transient left ventricular dysfunction in patients with normal coronary angiography findings. We report a case of Takotsubo cardiomyopathy with significant stenosis on coronary angiography. A 71-year-old woman was admitted to our hospital in a drowsy mental state. She was suspected to have diabetic ketoacidosis, but cardiac enzyme levels and electrocardiogram results were typical of myocardial infarction. Coronary angiography revealed occlusion of the distal right coronary artery. Echocardiography and left ventriculography revealed reduced left ventricular function with apical ballooning. However, coronary artery stenosis did not explain the severe reduction in left ventricular function. After 11 days, her left ventricular function and electrocardiogram results had returned to normal. Therefore, coronary artery disease does not rule out the presence of Takotsubo cardiomyopathy. (Korean J Med 2012;83:791-795)