scholarly journals Emotional Stress Induces Transient Left Ventricular Hypocontraction in the Rat Via Activation of Cardiac Adrenoceptors

2002 ◽  
Vol 66 (7) ◽  
pp. 712-712 ◽  
Author(s):  
Takashi Ueyama ◽  
Ken Kasamatsu ◽  
Takuzo Hano ◽  
Katsuhiro Yamamoto ◽  
Yoshihiro Tsuruo ◽  
...  
Keyword(s):  
Emotional Stress ◽  
Left Ventricular ◽  
Cardiac Adrenoceptors

scholarly journals Surgical treatment of left ventricular wall rupture, regarded as a consequence of Takotsubo cardiomyopathy

2017 ◽  
Vol 5 ◽  
pp. 2050313X1668921 ◽  
Author(s):  
Taalaibek Kudaiberdiev ◽  
Irina Akhmedova ◽  
Gulzada Imanalieva ◽  
Ildar Abdildaev ◽  
Kilichbek Jooshev ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Emotional Stress ◽  
Coronary Arteries ◽  
Takotsubo Cardiomyopathy ◽  
Laboratory Tests ◽  
Left Ventricular ◽  
Left Ventricular Aneurysm ◽  
Lv Function ◽  
Inferior Myocardial Infarction

Objective: We present the case of possible reverse type of TCM in a female patient presented with progressive left ventricular dysfunction and its rupture in pericardium. Methods: The detailed history, physical examination, laboratory tests, electrocardiography, serial echocardiography, coronary angiography with left ventriculography were performed to diagnose possible Takotsubo cardiomyopathy in 63-year old woman admitted to our center with complaints of dyspnea, lightheadedness, weakness and signs of hypotension and history of inferior myocardial infarction, acute left ventricular aneurysm, and effusive pericarditis and pleuritis, developed after emotional stress 5 months ago. Results: Clinical evaluation revealed unremarkable laboratory tests, normal troponin values, signs of old inferior myocardial infarction on electrocardiogram, and left ventricular (LV) dilatation and dysfunction, akinesia of LV infero-lateral wall with thinning and its rupture and blood shunting in pericardium. Her coronary angiography revealed normal coronary arteries. The diagnosis of pheochromocytoma was excluded. The patient underwent surgery under cardiopulmonary bypass with removal of LV pseudoaneurysm. The patient was discharged from hospital with improvement in NYHA class and LV function. Conclusion: Thus, in female postmenopausal patients presenting with acute myocardial infarction signs complicated by pericarditis, intact coronary arteries and LV dysfunction with emotional stress as triggering factor, reverse type of TCM should be considered and proper management applied to prevent development of life-threatening complications like LV rupture.

scholarly journals P1497 Atypical variant of takotsubo cardiomyopathy due to an unusual non-emotional trigger

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
O M Perez Fernandez ◽  
S A Higuera Leal ◽  
C P Jaimes ◽  
L M Contreras ◽  
J Gelves ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Emotional Stress ◽  
Takotsubo Cardiomyopathy ◽  
Wall Motion ◽  
Multimodality Imaging ◽  
Regional Wall Motion ◽  
Left Ventricular ◽  
Regional Wall ◽  
Regional Wall Motion Abnormalities ◽  
Wall Motion Abnormalities

Abstract Background Takotsubo Cardiomyopathy (TCM) is characterized by left ventricular regional wall motion abnormalities, classically described as apical ballooning (atypical features such as midventricular, basal, or focal wall motion abnormalities also have been described) and triggered by emotional or physical stress. In this case, TCM was triggered by non-emotional stress, and eventually an unusual definite diagnosis was ascertained based on pathological specimen. Case report a 63-year-old woman presented to the emergency room complaining of 5 days of epigastric pain, nausea and emesis followed by chest tightness, dyspnea and diaphoresis. Physical examination was noticeable for abdominal pain with positive Murphy´s sign. ECG showed normal sinus rhythm, with T-wave inversion in DIII and aVF, and elevated troponin I. She also had leukocytosis and neutrophilia with normal liver function tests. Abdominal ultrasound showed a distended gallbladder with gallstones, without definitive evidence of cholecystitis. Accordingly, she was admitted to the Coronary Care Unit with suspected Non-ST elevation myocardial infarction. Trans-thoracic echocardiogram (TTE) showed akinesia of all mid left ventricular segments with moderate systolic dysfunction -LVEF: 40%- (Figure 1A) suspicious for atypical TCM without a clear and identifiable emotional stress. Coronary angiography was negative for coronary stenosis and cardiac magnetic resonance (CMR) showed mid anterior and anterolateral segments dyskinesia, as well as mid septal, inferior and inferolateral segments akinesia (Figures 1B), with myocardial edema and no late gadolinium enhancement (Figure 1C), findings suggestive of TCM. Concomitant abdominal MRI demonstrated gallbladder distention, wall thickeningandedema, gallstones and peri-vesicular fat edema (Figure 1D). Consequently, an infrequent type 2 (mid-ventricular) TCM, triggered by abdominal pain and inflammatory response due to acute cholecystitis, was diagnosed. Surgery was differed until full recovery of left ventricular function. One month later, after a full course of antibiotics and a new TTE showing no regional wall motion abnormalities (Figure 1E), a cholecystectomy was performed. Surprisingly, pathology revealed acute on chronic cholecystitis with eosinophilic infiltration, findings compatible with subacute cholecystitis (surgery performed 4 weeks after onset of symptoms). Currently, the patient is followed by Gastro-enterology for additional work-up. Conclusion We highlight the importance of multimodality imaging during diagnostic approach of atypical TCM. In this case, TTE findings in addition to a normal coronary angiogram, resulted in clinical suspicion of mid-ventricular TCM (present in 15% of cases) which was confirmed by CMR during the index event, followed by a normal TTE 4 weeks later. Cholecystitis is one of the multiple physical stressors, in addition to emotional triggers, causing TCM. Abstract P1497 Figure.

Response of primate heart to emotional stress before and after cardiac denervation

1976 ◽  
Vol 230 (4) ◽  
pp. 988-995 ◽  
Author(s):  
DC Randall ◽  
MP Kaye ◽  
WC Randall ◽  
JV Brady ◽  
KH Martin
Keyword(s):  
Emotional Stress ◽  
Cardiovascular Response ◽  
Time Derivative ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Nervous Control ◽  
Small Magnitude ◽  
Ventricular Systolic Pressure ◽  
Cardiac Denervation ◽  
Before And After

Eleven chair-restrained rhesus monkeys were classically conditioned to a 1-min, 900-Hz tone (CSf) followed by food and a 1-min, 3.4-5Hz tone (CSs) followed by shock. Each conditional stimulus produced large, sudden, and highly significant (P less than .01) increases in left ventricular systolic pressure (LVP), its first time derivative (d(LVP)/dt), and heart rate (HR). The animal's hearts were sugically denervated following control studies of the conditional responses. Two to four weeks later, these responses were reexamined by again presenting CSf and CSs to five surviving monkeys following a format identical to that used in the control experiments. Complete cardiac denervation virtually eliminated the sudden increases in each of the measured variables. Denervation also "unmasked" small-magnitude, delayed chronotropic and inotropic responses during CSs (but not CSf). These effects were ascribed to the action of circulating catecholamines known to be secreted during "emotional" stress. Four monkeys studied for 6 mo or more postoperatively showed evidence for varying degrees of cardiac reinnervation. Loss of nervous control of the nonhuman primate heart greatly compromises the cardiovascular response to these environmental and behavioral stress situations.

scholarly journals Case report: Takotsubo cardiomyopathy in a patient with Alzheimer’s disease

2021 ◽  
Author(s):  
Isadora Vieira de Melo ◽  
Eduardo Guimarães Lacerda ◽  
Gustavo de Freitas Mendonça Gontijo ◽  
Hugo Haran Souza Andrade ◽  
Marlon Séles de Paula ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Case Report ◽  
Emotional Stress ◽  
Takotsubo Cardiomyopathy ◽  
Left Ventricular ◽  
Lv Function ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Multiple Drugs

Context: The Takotsubo cardiomyopathy (TTC) is an acute cardiac dysfunction, clinically similar to myocardial ischemia, more common in postmenopausal women and related to emotional stress. Case report: A 71-year-old female patient, with Alzheimer’s disease (AD), sought emergency care after severe chest pain. Electrocardiogram showed ST segment elevation in the anteroseptal wall. Physical exam: HR=108bpm, PA=126x78mmHg, SaO2=6%. Complementary exams showed a mild lesion in the middle third of the anterior descending artery, moderate impairment of left ventricular (LV) function by apical aneurysm without thrombi, mitral prolapse with mild reflux and an ejection fraction of 37%, suspecting of TTC. Conclusions: TTC is defined as a transient, usually reversible and segmental LV dysfunction, configuring a differential diagnosis of acute coronary syndrome. An overactivation of the sympathetic autonomic nervous system can cause catecholamine toxicity to the heart. Although several studies show a lower emotional response capacity in patients with cognitive impairment, more recent studies suggest that this emotional responsiveness is not so affected by dementia. Therefore, patients with AD may be susceptible to developing TTC, both because of the multiple drugs that they are exposed, increasing catecholamine levels, and because of the disease itself, that represents a stressful context. Thus, TTC is often associated with emotional stress and should not be overlooked in patients with AD.

scholarly journals Takotsubo or Stress Cardiomyopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
J. P. Bounhoure
Keyword(s):  
Left Ventricular Function ◽  
Ventricular Function ◽  
Emotional Stress ◽  
Case Reports ◽  
Coronary Thrombosis ◽  
Acute Chest Pain ◽  
Myocardial Damage ◽  
Left Ventricular ◽  
Coronary Syndrome ◽  
The Impact

Many case reports have been published of reversible left ventricular dysfunction precipitated by sudden emotional stress. We have evaluated 10 women hospitalized for acute chest pain and dyspnea, mimicking an acute coronary syndrome, after a severe emotional trigger. Those patients, postmenopausal women, presented ST segment alterations on the EKG, minor elevations of cardiac enzymes, and biomarkers levels. At the coronarography there was not coronary thrombosis or severe stenosis, but the ventriculography showed wall motion abnormalities involving the left ventricular apex and midventricle, in the absence of significant obstructive coronary disease. The course was benign without complication, with a full recovery of left ventricular function in some weeks. These observations, like other reports, demonstrate the impact of emotional stress on left ventricular function and the risk of cardiovascular disease. The cause of this cardiomyopathy is still unknown, and several mechanisms have been proposed: catecholamine myocardial damage, microvascular spasm, or neural mediated myocardial stunning.

Mitochondria in Cardiomyopathy: Alterations in Size, Number and Internal Structures

1968 ◽  
Vol 26 ◽  
pp. 126-127
Author(s):  
George Hug ◽  
William K. Schubert
Keyword(s):  
Heart Failure ◽  
Biochemical Analysis ◽  
Left Ventricular ◽  
Size Number ◽  
Internal Structures ◽  
Left Ventricular Outflow ◽  
Chest X Ray ◽  
Myocardial Fibers ◽  
Muscle Biopsies ◽  
Needle Liver Biopsy

A white boy six months of age was hospitalized with respiratory distress and congestive heart failure. Control of the heart failure was achieved but marked cardiomegaly, moderate hepatomegaly, and minimal muscular weakness persisted.At birth a chest x-ray had been taken because of rapid breathing and jaundice and showed the heart to be of normal size. Clinical studies included: EKG which showed biventricular hypertrophy, needle liver biopsy which showed toxic hepatitis, and cardiac catheterization which showed no obstruction to left ventricular outflow. Liver and muscle biopsies revealed no biochemical or histological evidence of type II glycogexiosis (Pompe's disease). At thoracotomy, 14 milligrams of left ventricular muscle were removed. Total phosphorylase activity in the biopsy specimen was normal by biochemical analysis as was the degree of phosphorylase activation. By light microscopy, vacuoles and fine granules were seen in practically all myocardial fibers. The fibers were not hypertrophic. The endocardium was not thickened excluding endocardial fibroelastosis. Based on these findings, the diagnosis of idiopathic non-obstructive cardiomyopathy was made.

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