Transient left ventricular dysfunction with apical ballooning (tako-tsubo cardiomyopathy) in Germany.

摘要: A peculiar type of an acute coronary syndrome is characterised by acute onset chest pain, STsegment changes, elevated troponin I levels and a transient balloon–like apical left ventricular dysfunction, but without significant coronary artery disease. We sought to assess this syndrome in German patients. A total 22 females 1 male with acute transient left ventricular dysfunction were identified during an interval 2 years were investigated clinically angiographically. All patients presented without obstructive coronary artery disease. In 16 (70%) ST–segment elevations observed mimicking myocardial infarction, whereas the remaining patients (30%) revealed only negative T waves. Deep negative Twaves characteristically seen during course recovery in all patients. Elevated troponin I levels > 2.0 µg/l (upper level of normal) measured patients (mean 18 ± 26.5 µg/l, range from 2.2–135.7 µg/l). Creatine kinase rose up to mean of 282 236 IU/l normal 180 U/l). Emotional or physical stress situations associated with symptoms were observed patients (70%). Other suspected trigger factors gastrointestinal infection and one case surgical intervention. four a trigger factor could not be identified. Left ventriculography showed an ejection fraction 53 15%. After 7 days after the first angiogram, fraction had increased from 48 11% to 64 11% eight controlled patients by repeated ventriculography. Coronary spasm with a lumen reduction 75% be provoked using acetylcholine 10 of 17 tested (59%) with reproduction symptoms. Within 14 LV dysfunction returned normal patients. The ECG abnormalities disappeared completely as early as 3 months (74%) seen in any patient after 6 months. Tako–tsubo cardiomyopathy is exclusively a Japanese Northern American phenomenon. Despite increased patient reports exact underlying cause pathophysiology of this remain unclear. However, despite initial dramatic presentation disease the prognosis good.