Cirugía y Cirujanos

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board

>Journals >Cirugía y Cirujanos >Year 2010, Issue 2

Pacheco-Bouthillier AD, Maza-Juárez G, Vargas-Guzmán RM, Santiago-Hernández J, Almeida-Gutiérrez E, Borrayo-Sánchez G
Síndrome de takotsubo. Informe de un caso y revisión de la literatura
Cir Cir 2010; 78 (2)

Language: Español
References: 25
Page: 157-161
PDF: 327.13 Kb.

[Full text - PDF]


Background: Takotsubo Syndrome is a cardiopathy characterized by a dyskinesia or left ventricular apical ballooning and subsequent recovery of ventricular function. We undertook this study to present a case of Takotsubo syndrome.
Clinic case: We present the case of a 60-year-old female with a 26-year history of systemic arterial hypertension treated with 40 mg of termisartan daily. She started with headache after an emotional event (as a witness to an aggression of her son), associated with elevation of blood pressure that suddenly was accompanied by intense oppressive chest pain and neurovegetative symptoms. Electrocardiogram showed ST-segment elevation in anteroseptal and lateral derivations. Catheterization showed a 50% obstruction in the anterior descending artery and apical dyskinesia with base hypercontractility and 35% left ventricular ejection fraction. We performed stent angioplasty in the responsible artery. Nuclear medicine study showed extensive apical infarction, and echocardiogram agreed with transient apical dyskinesia and basal hypercontractility. After a 1-month evolution, echocardiogram mobility was completely recovered and myocardial perfusion study was normal 4 months later.
Conclusions: We show a transitory apical ballooning secondary to acute myocardial infarction associated with a significantly stressful event that resulted in complete improvement of ventricular function with percutaneous coronary intervention during the following 4 months.

Key words: Takotsubo syndrome, ballooning, acute myocardial infarction, percutaneous coronary intervention.


  1. Par J, Gómez R. Síndrome Tako-tsubo (discinesia antero-apical transitoria). Primer caso descrito en América Latina y revisión de la literatura. Arch Cardiol Mex 2004;74:205-214.

  2. Cherian J, Angelis D, Filiberti A, Saperia G. Can Takotsubo cardiomyopathy be familial? Int J Cardiol 2007;121:74-75.

  3. Pilgrim T, Wyss T. Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrome: a systematic review. Int J Cardiol 2008;124:283-292.

  4. Takizawa M, Kobayakawa N, Uozumi H, Yonemura S, Kodama T, Fukusima K, et al. A case of transient left ventricular ballooning with pheochromocytoma, supporting pathogenetic role of catecholamines in stress-induced cardiomyopathy or Takotsubo cardiomyopathy. Int J Cardiol 2007;114:e15-e17.

  5. Cheng T. Pathophysiologic mechanisms of left ventricular apical ballooning in Takotsubo cardiomyopathy. Int J Cardiol 2009;133:249.

  6. Ibáñez B, Navarro F, Farré J, Marcos-Alberca P, Orejas M, Rábago R. Asociación del síndrome tako-tsubo con la arteria coronaria descendente anterior con extensa distribución por el segmento diafragmático. Rev Esp Cardiol 2004;57:209-216.

  7. Farre J. Takotsubo syndrome: a bayesian approach to interpreting its pathogenesis. Mayo Clin Proc 2006;81:732-735.

  8. Bybee KA, Motiei A, Syed IS, Kara T, Prasad A, Lennon RJ, et al. Electrocardiography cannot reliably differentiate transient left ventricular apical ballooning syndrome from anterior ST-segment elevation myocardial infarction. J Electrocardiol 2007;40:38.e1-e6.

  9. Ogura R, Hiasa Y, Takahashi T, Yamaguchi K, Fujiwara K, Ohara Y, et al. Specific findings of the standard 12-lead ECG in patients with ‘takotsubo’ cardiomyopathy: comparison with the findings of acute anterior myocardial infarction. Circ J 2003;67:687-690.

  10. Akashi YJ, Nakazawa K, Sakakibara M, Miyake F, Koike H, Sasaka K. The clinical features of takotsubo cardiomyopathy. Q J Med 2003;96:563-573.

  11. Wittstein I, Thiemann D, Lima J, Baughman K, Schulman S, Gerstenblith G, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med 2005;352:539-548.

  12. Akashi YJ, Musha H, Nakazawa K. Plasma brain natriuretic peptide in takotsubo cardiomyopathy. Q J Med 2004;97:599-607.

  13. Caselli S, Passaseo I, Giannantoni P, Santini D, Marcantonio A, DeCastro S. 2-and 3-dimensional echocardiographic analysis of an unusual transient apical ballooning. J Am Soc Echocardiogr 2008;21:511.e1-e4.

  14. Shah D, Sugeng L, Goonewardena S, Coon P, Lang R. Takotsubo cardiomyopathy. Circulation 2006;113:e762.

  15. Nishikawa S, Ito K, Adachi Y, Katoh S, Azuma A, Matsubara H. Ampulla (‘Takotsubo’) cardiomyopathy of both ventricles evaluation of microcirculation disturbance using 99mTc-tetrofosmin myocardial single photon emission computed tomography and doppler guide wire. Circ J 2004;68:1076-1080.

  16. Feola M, Chauvie S, Rosso G, Biggi A, Ribichini F, Bobbio M. Reversible impairment of coronary flow reserve in takotsubo cardiomyopathy: a myocardial PET study. J Nucl Cardiol 2008;15:811-817.

  17. Cimarelli S, Imperiale A, Ben-Sellem D, Rischner J, Detour J, Morel O, et al. Nuclear medicine imaging of Takotsubo cardiomyopathy: typical form and midventricular ballooning syndrome. J Nucl Cardiol 2008;15:137-141.

  18. Leurent G, Langella B, Boulmier D, Larralde A, Donal E, Bedossa M, et al. Apport de l’IRM cardiaque dans le diagnostic étiologique des síndromes douloureux thoraciques à réseau coronaire angiographiquement normal. Ann Cardiol Ang 2008;57:109-115.

  19. Haghi D, Fluechter S, Suselbeck T, Kaden J, Borggrefe M, Papavassiliu T. Cardiovascular magnetic resonance findings in typical versus atypical forms of the acute apical ballooning syndrome (Takotsubo cardiomyopathy). Int J Cardiol 2007;120:205-211.

  20. Sachio K, Akira K, Hitonobu T; Takotsubo Cardiomyopathy Study Group. Guidelines for Diagnosis of Takotsubo (Ampulla) Cardiomyopathy. Circ J 2007;71:990-992.

  21. Akashi Y, Tejima T, Sakurada H, Matsuda H, Suzuki K, Kawasaki K, et al. Left ventricular rupture associated with Takotsubo cardiomyopathy. Mayo Clin Proc 2004;79:821-824.

  22. Cherian J, Kothari S, Angelis D, Atef A, Downey B, Kirkpatrick J. Atypical Takotsubo cardiomyopathy. Tex Heart Inst J 2008;35:73-75.

  23. Takuji Y, Akiyoshi H, Kazufumi T, Nagao K, Kyuma M, Ooiwa H, et al. Clinical implications of midventricular obstruction and intravenous propranolol use in transient left ventricular apical ballooning (Tako-tsubo cardiomyopathy). Am Heart J 2008;155:526.e1-526.e7.

  24. Fazio G, Novo G, Barbaro G, Sutera L, Azzarelli S, Palecek T, et al. Treatment of Tako-tsubo cardiomyopathy. Int J Cardiol 2008;130:475-476.

  25. Fazio G, Pizzuto C, Barbaro G, Sutera L, Incalcaterra E, Evola G, et al. Chronic pharmacological treatment in takotsubo cardiomyopathy. Int J Cardiol 2008;127:121-123.

>Journals >Cirugía y Cirujanos >Year 2010, Issue 2

· Journal Index 
· Links 
Copyright 2010