Takotsubo Cardiomyopathy Complicating Sick Sinus Syndrome

Transcription

1 Takotsubo Cardiomyopathy Complicating Sick Sinus Syndrome Jun Kim MD Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea Takotsubo cardiomyopathy complicating sick sinus syndrome ABSTRACT Takotsubo cardiomyopathy presents with diverse electrocardiographic changes, possibly masquerading as an acute coronary syndrome, and may occur after psychological, medical, or surgical stress. We describe a case of a 69-year-old woman with sick sinus syndrome, repolarization abnormalities, akinesia of the left ventricular apex, and normal coronary arteries. The patient s electrocardiographic and echocardiographic abnormalities normalized after the implantation of a permanent pacemaker; cardiac events did not recur within a 5-year follow-up period. Key words: pacemaker sick sinus syndrome takotsubo cardiomyopathy Received: January 20, 2013 Accepted: June 30, 2013 Correspondence: Jun Kim, MD, Department of Internal Medicine, Pusan National University Yangsan Hospital, Geum-o Street 20, Yangsan , Republic of Korea Tel: , Fax: mdjunkim@gmail.com 24 The Official Journal of Korean Heart Rhythm Society

2 ECG & EP CASES VOL.14 NO.2 25

3 A B C Figure 1. Surface electrocardiograms of the patient: (A) electrocardiogram at initial presentation, (B) after implantation of the pacemaker, and (C) 5 months after the implantation of a pacemaker. 26 The Official Journal of Korean Heart Rhythm Society

4 A C E B D F Figure 2. Apical 4-chamber views of the left ventricle. End-systolic and end-diastolic images at initial presentation (A, B), 2 days after pacemaker implantation (C, D), and 2 months after pacemaker implantation (E, F). A B Figure 3. Left ventriculogram of the patient: (A) end-systolic frame and (B) end-diastolic frame. VOL.14 NO.2 27

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