J Korean Soc Emerg Med.  2017 Aug;28(4):380-386. 10.0000/jksem.2017.28.4.380.

A Case of Ventricular Septal Rupture in Stress Cardiomyopathy

• Chung H

• KMID: 2393982
• DOI: http://doi.org/10.0000/jksem.2017.28.4.380

Abstract

Stress cardiomyopathy (SCMP) is a reversible heart disease, commonly accompanied by emotional or physical stress. Early clinical features are similar to those of acute myocardial infarction, such as acute chest symptoms, ST-segment elevation on electrocardiography, and cardiac biomarkers elevation. However, there is usually no evidence of significant coronary obstruction on a coronary angiogram. Moreover, ventricular dysfunction with regional wall motion abnormalities does not correlate with a single vascular territory. The typical type of SCMP is apical wall motion abnormality with an apical ballooning pattern, and various types of SCMP have recently been reported. Generally, cardiac dysfunction or abnormal wall motion is improved within several weeks, and the prognosis of SCMP is generally good. Thus, the mainstay of the treatment is largely conservative. However, there are some serious complications during the acute phase. In particular, cardiac rupture is a rare but serious structural complication associated with high mortality. In this manner, SCMP could potentially be life threatening during the acute phase, despite it generally being a benign disease in most cases. Early recognition of this complication, appropriate medical therapy, and surgical intervention are required to improve recovery and survival. Here, I report a case of an 83-year-old female patient with SCMP complicated by ventricular septal rupture.

Keyword

Stress; Cardiomyopathies; Ventricular septal rupture; Myocardial infarction

MeSH Terms

Aged, 80 and over
Biomarkers
Cardiomyopathies
Electrocardiography
Female
Heart Diseases
Heart Rupture
Humans
Mortality
Myocardial Infarction
Prognosis
Takotsubo Cardiomyopathy*
Thorax
Ventricular Dysfunction
Ventricular Septal Rupture*
Biomarkers