León AE, Goicolea RJ, Jiménez-Blanco BM

Language: Spanish
References: 0
Page: 183-184
PDF size: 288.97 Kb.

Text Extraction

83-year-old woman without known cardiovascular risk factors and no clinical signs of ischemia or heart failure after the implantation of a pacemaker (15 years ago); who was sent by the emergency medical services to the Hospital Universitario "Puerta de Hierro", after an episode of oppressive thoracic pain, accompanied by dyspnea and anxiety, after a situation of important psychological stress. During the transfer, her symptoms abated gradually; thus, she arrived asymptomatic to the hospital. Minimum ST segment elevation was observed in the electro-cardiogram, on high lateral wall leads, with minor inferior wall rectification and negative T wave in DIII. The troponin I at admission was of 2.65 µg/L (maximum of 7.34) and the emergency echocardiogram (Panel A) reported a non dilated left ventricle with septal hypertrophy, akinesia of anterior, anteroseptal and inferoseptal wall segments, with moderately decreased systolic function (ejection fraction [EF]: 35%). Suspecting a stress-induced cardiomyopathy, she was oriented a coronary angiography, 48 hours later to the admission, where coronary arteries without angiographic stenosis or evidence of unstable plaque (Panel B) were confirmed. The ventriculography (Paneles C y D), in right anterior oblique view 30°, showed a focal akinesia of the middle segment of the anterior wall and normokinesis of the other segments (Panel E), with a calculated EF of 64%.