J Cardiovasc Ultrasound.  2008 Dec;16(4):123-125. 10.4250/jcu.2008.16.4.123.

A Case of Consecutive Right and Left Ventricular Dysfunction

• Park SM
• Choi JI
• Hong SJ
• Lim DS
• Shim WJ

• KMID: 1486391
• DOI: http://doi.org/10.4250/jcu.2008.16.4.123

Abstract

An acute pulmonary embolism (PE) and the apical ballooning syndrome (ABS) are both critical and need proper management during the acute stage. We experienced a case of recurrent severe dyspnea because serious right ventricular dysfunction due to PE and left ventricular dysfunction due to ABS occurred consecutively in the short-term and bedside echocardiography has an important role in management in acute settings.

Keyword

Pulmonary embolism; Apical ballooning syndrome; Bleeding; Echocardiography

MeSH Terms

Dyspnea
Echocardiography
Hemorrhage
Pulmonary Embolism
Takotsubo Cardiomyopathy
Ventricular Dysfunction, Left
Ventricular Dysfunction, Right

Figure

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  Fig. 1 Initial transthoracic echocardiography for severe dyspnea. Significantly enlarged RV and RA and D-shaped LV were observed (A, B). Calculated PA systolic pressure is 74 mmHg (C). She was diagnosed with acute pulmonary embolism. RV: right ventricle, RA: right atrium, LV: left ventricle, PA: pulmonary artery.

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  Fig. 2 Follow-up transthoracic echocardiography for second episode of severe dyspnea. On hospital day 8, RV overloading is much improved with a decreased PA systolic pressure of 34 mmHg (C). In contrast, LV and LA are enlarged. LV has a balloon-like akinetic apex and hyperkinetic basal walls (A, B). She was diagnosed with apical ballooning syndrome. RV: right ventricle, RA: right atrium, LV: left ventricle, LA: left atrium, PA: pulmonary artery.

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