TY - JOUR
T1 - Two cases of apical ballooning syndrome masking apical hypertrophic cardiomyopathy
AU - Roy, Ranjini Raina
AU - Hakim, Fayaz A.
AU - Hurst, R. Todd
AU - Simper, David
AU - Appleton, Christopher P.
N1 - Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2014/4
Y1 - 2014/4
N2 - Apical akinesis and dilation in the absence of obstructive coronary artery disease is a typical feature of stress-induced (takotsubo) cardiomyopathy, whereas apical hypertrophy is seen in apical-variant hypertrophic cardiomyopathy. We report the cases of 2 patients who presented with takotsubo cardiomyopathy and were subsequently found to have apicalvariant hypertrophic cardiomyopathy, after the apical ballooning from the takotsubo cardiomyopathy had resolved. The first patient, a 43-year-old woman with a history of alcohol abuse, presented with shortness of breath, electrocardiographic and echocardiographic features consistent with takotsubo cardiomyopathy, and no significant coronary artery disease. An echocardiogram 2 weeks later revealed a normal left ventricular ejection fraction and newly apparent apical hypertrophy. The 2nd patient, a 70-year-old woman with pancreatitis, presented with chest pain, apical akinesis, and a left ventricular ejection fraction of 0.39, consistent with takotsubo cardiomyopathy. One month later, her left ventricular ejection fraction was normal; however, hypertrophy of the left ventricular apex was newly noted. To our knowledge, these are the first reported cases in which apical-variant hypertrophic cardiomyopathy was masked by apical ballooning from stress-induced cardiomyopathy.
AB - Apical akinesis and dilation in the absence of obstructive coronary artery disease is a typical feature of stress-induced (takotsubo) cardiomyopathy, whereas apical hypertrophy is seen in apical-variant hypertrophic cardiomyopathy. We report the cases of 2 patients who presented with takotsubo cardiomyopathy and were subsequently found to have apicalvariant hypertrophic cardiomyopathy, after the apical ballooning from the takotsubo cardiomyopathy had resolved. The first patient, a 43-year-old woman with a history of alcohol abuse, presented with shortness of breath, electrocardiographic and echocardiographic features consistent with takotsubo cardiomyopathy, and no significant coronary artery disease. An echocardiogram 2 weeks later revealed a normal left ventricular ejection fraction and newly apparent apical hypertrophy. The 2nd patient, a 70-year-old woman with pancreatitis, presented with chest pain, apical akinesis, and a left ventricular ejection fraction of 0.39, consistent with takotsubo cardiomyopathy. One month later, her left ventricular ejection fraction was normal; however, hypertrophy of the left ventricular apex was newly noted. To our knowledge, these are the first reported cases in which apical-variant hypertrophic cardiomyopathy was masked by apical ballooning from stress-induced cardiomyopathy.
KW - Cardiomyopathy
KW - Heart ventricles/physiopathology
KW - Hypertrophic/complications/diagnosis
KW - Left
KW - Takotsubo cardiomyopathy/diagnosis/physiopathology
KW - Time factors
KW - Ventricular dysfunction
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U2 - 10.14503/THIJ-13-3191
DO - 10.14503/THIJ-13-3191
M3 - Article
C2 - 24808780
AN - SCOPUS:84898921013
SN - 0730-2347
VL - 41
SP - 179
EP - 183
JO - Texas Heart Institute Journal
JF - Texas Heart Institute Journal
IS - 2
ER -