scholarly journals “Reverse McConnell's Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy

2015 ◽  
Vol 9s1 ◽  
pp. CMC.S18756 ◽  
Author(s):  
Kan Liu ◽  
Zhongxia Sun ◽  
Tiemin Wei
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Takotsubo Cardiomyopathy ◽  
Clinical Course ◽  
Hemodynamic Instability ◽  
Anterior Wall ◽  
Diagnostic Dilemma ◽  
Hemodynamic Compromise ◽  
Left And Right

Although most patients with Takotsubo cardiomyopathy (TTC) have benign clinical course and prognosis, TTC can induce acute heart failure and hemodynamic instability. TTC mimics the clinical features of acute anterior wall myocardial infarction (AMI). Bedside clinicians often have a diagnostic dilemma when cardiac catheterization and angiography are either contraindicated or can cause potential adverse consequences. Misdiagnosing TTC as AMI will lead to initiation of harmful pharmacological or device-based treatment, which worsens hemodynamic compromise. Therefore, understanding and interpreting the unique pathophysiological and hemodynamic features of TTC in a better manner becomes crucial to guide effective clinical management of acute heart failure/cardiogenic shock during TTC. We review recent advances in echocardiographic diagnosis of TTC and its role in guiding bedside management of acute heart failure and cardiogenic shock, with specific focus on the interpretation of discrepant, but reciprocally dependent, left and right ventricular hemodynamics during acute stages of TTC.

scholarly journals Pheochromocytoma-Induced Takotsubo Cardiomyopathy

2019 ◽  
Vol 46 (2) ◽  
pp. 124-127 ◽  
Author(s):  
Majed Afana ◽  
Rishi J. Panchal ◽  
Rebecca M. Simon ◽  
Amal Hejab ◽  
Sharon W. Lahiri ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Takotsubo Cardiomyopathy ◽  
Adrenal Mass ◽  
Severe Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Biochemical Tests ◽  
Ventricular Ejection Fraction ◽  
Hemodynamic Compromise

Pheochromocytoma, a rare catecholamine-secreting tumor, typically manifests itself with paroxysmal hypertension, tachycardia, headache, and diaphoresis. Less often, symptoms related to substantial hemodynamic compromise and cardiogenic shock occur. We report the case of a 66-year-old woman who presented with abdominal pain. Examination revealed a large right adrenal mass, cardiogenic shock, and severe heart failure in the presence of normal coronary arteries. Within days, the patient's hemodynamic status and left ventricular ejection fraction improved markedly. Results of imaging and biochemical tests confirmed the diagnosis of pheochromocytoma-induced takotsubo cardiomyopathy. Medical therapy and right adrenalectomy resolved the patient's heart failure, and she was asymptomatic postoperatively. We recommend awareness of the link between pheochromocytoma and takotsubo cardiomyopathy, and we discuss relevant diagnostic and management principles.

Life-threatening Takotsubo Cardiomyopathy

2011 ◽  
Vol 9 (2) ◽  
pp. 119 ◽  
Author(s):  
Karen Mrejen-Shakin ◽  
Ricardo Lopez ◽  
Mohandas M Shenoy ◽  
◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Acute Heart Failure ◽  
Takotsubo Cardiomyopathy ◽  
Stress Test ◽  
Systolic Dysfunction ◽  
Apical Ballooning ◽  
Assisted Ventilation ◽  
Two Dimensional ◽  
Life Threatening

Objective:To report a case of seizure-induced takotsubo cardiomyopathy with rare etiology and rarer complications.Methods:A 50-year-old woman had multiple epileptic seizures and later developed acute heart failure complicated by ventricular fibrillation and shock. A two-dimensional echocardiogram revealed apical ballooning of the left ventricle resembling a takotsubo (a Japanese fisherman's pot used to trap octopi). The apex was also hypokinetic.Results:The hemodynamic abnormalities normalized with defibrillation, assisted ventilation, inotropic support, and pressor agents. More importantly, the apical ballooning deformity and systolic dysfunction reversed. The echocardiogram normalized three months later. A nuclear treadmill stress test was negative for ischemia.Conclusions:Apical ballooning of the left ventricle and hypokinesis are typical echocardiographic features in takotsubo cardiomyopathy, a stress-induced heart disease. It may follow severe emotional, physical, and neurologic stressors, in our rare case, grand mal seizures (0.2 % of all takotsubo disease patients). Also rare are life-threatening complications. Based on these observations, in a case with severe stress followed by acute heart failure, takotsubo cardiomyopathy should be a major diagnostic consideration. The dramatic initial triggering event, in our case an epileptic seizure, should not mask the possibility of coexisting takotsubo cardiomyopathy. Awareness of this disease, anticipation of complications, and two-dimensional echocardiography will help channel the management in the right direction.

scholarly journals P602Growth differentiation factor-15 predicts mortality in acute heart failure and cardiogenic shock

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
W.S. Speidl ◽  
S.P. Kastl ◽  
K.A. Krychtiuk ◽  
M. Lenz ◽  
J. Wojta ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Differentiation Factor

scholarly journals ANMCO POSITION PAPER: Role of intra-aortic balloon pump in patients with acute advanced heart failure and cardiogenic shock

2021 ◽  
Vol 23 (Supplement_C) ◽  
pp. C204-C220
Author(s):  
Roberta Rossini ◽  
Serafina Valente ◽  
Furio Colivicchi ◽  
Cesare Baldi ◽  
Pasquale Caldarola ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Advanced Heart Failure ◽  
Position Paper ◽  
Present Position ◽  
Intra Aortic Balloon Pump ◽  
All Cause Mortality ◽  
Practical Recommendations

Abstract The treatment of patients with advanced acute heart failure is still challenging. Intra-aortic balloon pump (IABP) has widely been used in the management of patients with cardiogenic shock. However, according to international guidelines, its routinary use in patients with cardiogenic shock is not recommended. This recommendation is derived from the results of the IABP-SHOCK II trial, which demonstrated that IABP does not reduce all-cause mortality in patients with acute myocardial infarction and cardiogenic shock. The present position paper, released by the Italian Association of Hospital Cardiologists, reviews the available data derived from clinical studies. It also provides practical recommendations for the optimal use of IABP in the treatment of cardiogenic shock and advanced acute heart failure.

Acute heart failure and cardiogenic shock

2013 ◽  
pp. 309-316
Author(s):  
Demosthenes G. Katritsis ◽  
Bernard J. Gersh ◽  
A. John Camm
Keyword(s):  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure

Dyspnoea in patients with acute heart failure: an analysis of its clinical course, determinants, and relationship to 60-day outcomes in the PROTECT pilot study

2010 ◽  
Vol 12 (5) ◽  
pp. 499-507 ◽  
Author(s):  
Marco Metra ◽  
John G. Cleland ◽  
Beth Davison Weatherley ◽  
Howard C. Dittrich ◽  
Michael M. Givertz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pilot Study ◽  
Acute Heart Failure ◽  
Clinical Course

scholarly journals Acute heart failure following myocardial infarction: complement activation correlates with the severity of heart failure in patients developing cardiogenic shock

2018 ◽  
Vol 5 (3) ◽  
pp. 292-301 ◽  
Author(s):  
Hilde L. Orrem ◽  
Per H. Nilsson ◽  
Søren E. Pischke ◽  
Guro Grindheim ◽  
Peter Garred ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiogenic Shock ◽  
Acute Heart Failure ◽  
Complement Activation
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