J Cardiovasc Ultrasound.  2011 Jun;19(2):87-90. 10.4250/jcu.2011.19.2.87.

Stress Cardiomyopathy Complicated by Left Ventricular Thrombi and Cerebral Infarctions in a Patient with Essential Thrombocythemia

• Hwang SH
• Kim KH
• Yoon HJ
• Hong YJ
• Kim JH
• Ahn YK
• Jeong MH
• Cho JG
• Park JC
• Kang JC

• KMID: 1980357
• DOI: http://doi.org/10.4250/jcu.2011.19.2.87

Abstract

The prognosis of stress induced cardiomyopathy (SCMP) is generally known to be excellent, however, several fatal complications such as cardiac rupture and left ventricular (LV) thrombosis with subsequent embolic complications have been described. We report a rare case of SCMP complicated by LV thrombosis and multiple cerebral infarctions in a patient with essential thrombocythemia. After intravenous anticoagulation with heparin and general managements for heart failure and cerebral infarctions, her neurologic symptoms and the wall motion abnormalities of the LV apex were improved, and the thrombus was disappeared on follow-up echocardiography.

Keyword

Cardiomyopathy; Thrombocythemia; Thromboembolism

MeSH Terms

Cardiomyopathies
Cerebral Infarction
Echocardiography
Follow-Up Studies
Heart Failure
Heart Rupture
Heparin
Humans
Neurologic Manifestations
Prognosis
Takotsubo Cardiomyopathy
Thrombocythemia, Essential
Thrombocytosis
Thromboembolism
Thrombosis
Heparin

Figure

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  Fig. 1 Diffusion weighted (A and C) and apparent diffusion coefficient (B and D) brain magnetic resonance imaging show acute cerebral infarction in the left middle cerebral artery territory (A and B, arrow) and right posterior inferior cerebellar artery territory (C and D, arrow).

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  Fig. 2 Transthoracic echocardiography at admission reveals akinesia and systolic bulging of apical segments with thrombi formation (A and B, arrow). The wall motion abnormalities of the left ventricular are normalized and the apical thrombi are resolved completely on follow-up echocardiographic examination (C and D).

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