1/3. Transient increase in wall thickness of the left ventricular apex during recovery from "ampulla" cardiomyopathy."Ampulla" cardiomyopathy is a syndrome characterized by transient abnormal left ventricular wall motion with hypokinesia around the apical area and hyperkinesia at the basal area, without any detectable coronary lesion. Two cases of transient wall thickening of the left ventricular apex during recovery from "ampulla" cardiomyopathy are described. Apical wall thickening was documented by left ventriculography, echocardiography, and thallium (201Tl) single-photon emission computed tomography (SPECT) during the recovery phase. The thickness of the apical wall subsequently returned to normal. Both patients underwent provocation tests. Coronary spasms were positive. This transient increase in left ventricular apical volume may have been caused by myocardial inflammation secondary to "ampulla" cardiomyopathy.- - - - - - - - - - ranking = 1keywords = hyperkinesia (Clic here for more details about this article) |
2/3. 'Takotsubo' cardiomyopathy in a maintenance hemodialysis patient.An 84-year-old woman undergoing maintenance hemodialysis presented with chest discomfort lasting several days and electrocardiographic abnormalities. She had stopped smoking 2 weeks earlier and was experiencing irritability. Upon admission, electrocardiography showed ST-segment elevation in leads I, II, aVF, and V2-6 and an abnormal Q wave in leads II, III, and aVF. Ultrasound cardiography showed left ventricular anteroapical akinesia and basal hyperkinesia. The chest discomfort disappeared without specific therapy. During hospital days 1-5, the ST-segment elevation gradually improved. Giant negative T waves then developed. The left ventricular asynergy resolved by day 8. radionuclide imaging with iodine-123-beta-methyl-p-iodophenyl pentadecanoic acid, but not with technetium-99 m-sestamibi, showed an apical defect. Elective coronary angiography showed no stenosis. 'Takotsubo' cardiomyopathy was diagnosed. After discharge, the patient continued regular dialysis without cardiac symptoms. We concluded that endogenously activated sympathetic nerve action in hemodialysis patients, especially those under emotional or physical stress, might be a causative factor for takotsubo cardiomyopathy.- - - - - - - - - - ranking = 1keywords = hyperkinesia (Clic here for more details about this article) |
3/3. Transient stress-induced cardiomyopathy with an "inverted takotsubo" contractile pattern.We describe a patient who had transient cardiomyopathy with akinesia of the basal portions of the left ventricle and hyperkinesia of the apex triggered by alcoholic pancreatitis. This case seems to confirm recent publications suggesting a new or variant clinical entity with a clinical presentation similar to that of takotsubo cardiomyopathy but with an Inverse left ventricular contractile pattern ("Inverted Takotsubo"). This entity could provide clues to the underlying pathophysiology of these syndromes of acute heart injury.- - - - - - - - - - ranking = 1keywords = hyperkinesia (Clic here for more details about this article) |