Premium
‘Takotsubo’ Cardiomyopathy in a Maintenance Hemodialysis Patient
Author(s) -
Fukui Masayoshi,
Mori Yasukiyo,
Tsujimoto Satoshi,
Takehana Kazuya,
Sakamoto Norihiko,
Kishimoto Noriko,
Imada Takanobu,
Maeba Hirofumi,
Nose Atsuko,
Yamahara Hideki,
Kijima Yasuaki,
Kitamura Tetsuya,
Ueyama Takanao,
Kikuchi Sanae,
Tokoro Toshiko,
Masaki Hiroya,
Nishikawa Mitsushige,
Iwasaka Toshiji
Publication year - 2006
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2006.00308.x
Subject(s) - medicine , asynergy , cardiology , cardiomyopathy , hyperkinesia , irritability , t wave , hemodialysis , palpitations , st segment , electrocardiography , chest pain , st elevation , heart failure , ejection fraction , radionuclide ventriculography , menopause , myocardial infarction
An 84‐year‐old woman undergoing maintenance hemodialysis presented with chest discomfort lasting several days and electrocardiographic abnormalities. She had stopped smoking 2 weeks earlier and was experiencing irritability. Upon admission, electrocardiography showed ST‐segment elevation in leads I, II, aVF, and V 2‐6 and an abnormal Q wave in leads II, III, and aVF. Ultrasound cardiography showed left ventricular anteroapical akinesia and basal hyperkinesia. The chest discomfort disappeared without specific therapy. During hospital days 1–5, the ST‐segment elevation gradually improved. Giant negative T waves then developed. The left ventricular asynergy resolved by day 8. Radionuclide imaging with iodine‐123‐beta‐methyl‐p‐iodophenyl pentadecanoic acid, but not with technetium‐99 m‐sestamibi, showed an apical defect. Elective coronary angiography showed no stenosis. ‘Takotsubo’ cardiomyopathy was diagnosed. After discharge, the patient continued regular dialysis without cardiac symptoms. We concluded that endogenously activated sympathetic nerve action in hemodialysis patients, especially those under emotional or physical stress, might be a causative factor for Takotsubo cardiomyopathy.