alexa Ventricular Septal Perforation Following Takotsubo Cardiomyopathy | Open Access Journals
Cardiovascular Therapy: Open Access
Like us on:
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Ventricular Septal Perforation Following Takotsubo Cardiomyopathy

Shintaro Yamazaki1*, Masanori Kato1 and Masaaki Toyama2

1Department of Cardiovascular Surgery, Fuji Heavy Industries Health Insurance Society Ota Memorial Hospital, Gunma, Japan

2Department of Cardiac & Vascular Surgery, Kameda Medical Center, Chiba, Japan

*Corresponding Author:
Shintaro Yamazaki MD
Department of Cardiovascular Surgery
Ota Memorial Hospital, 455-1 Oshimacho
Ota City 373-8585, Gunma, Japan
Tel: +080-3909-8035
E-mail: [email protected]

Received Date: October 03, 2016; Accepted Date: November 03, 2016; Published Date: November 10, 2016

Citation: Yamazaki S, Kato M, Toyama M (2016) Ventricular Septal Perforation Following Takotsubo Cardiomyopathy. Cardiovasc Ther 1: 113.

Copyright: © 2016 Yamazaki S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Cardiovascular Therapy: Open Access

Abstract

Ventricular septal perforation is a well-known complication following acute myocardial infarction, but it rarely complicates takotsubo cardiomyopathy. A 76-year-old woman, who had dyspnea, had been admitted for takotsubo cardiomyopathy. Systolic murmur that was loudest at the apex was heard. Transthoracic echocardiography revealed shunt flow from the left ventricle to the right ventricle. Ventricular septal perforation following takotsubo cardiomyopathy was diagnosed. Intra-aortic balloon pumping was immediately started. We successfully performed patch repair. Takotsubo cardiomyopathy complicated by ventricular septal perforation is a rare and critical condition that requires optimal treatment and careful monitoring.

Case Report

Ventricular septal perforation is a well-known complication following acute myocardial infarction, but it has rarely complicated takotsubo cardiomyopathy [1].

We report a rare case of ventricular septal perforation after takotsubo cardiomyopathy (TCM-VSP), which was successfully treated by surgery.

A 76-year-old woman was admitted for bowel obstruction caused by an ascending colon tumor. The patient was under treatment for hypertension and diabetes. Dyspnea occurred after three days. Electrocardiography showed ST elevation in leads V1-V6. The elevation suggested acute myocardial infarction and coronary arteriography was performed. No coronary lesion was present (Figure 1), but an absence of apical contraction and an excessive base contraction were noted on the left ventriculography (Figure 2). Takotsubo cardiomyopathy was diagnosed. The symptoms improved after inpatient treatment, but there was sudden onset of severe dyspnea after four days. Levine 4/6 pansystolic murmur that was loudest at the apex was heard. Transthoracic echocardiography revealed shunt flow from the left ventricle to the right ventricle (Figure 3). TCM-VSP was diagnosed. Intra-aortic balloon pumping was immediately started.

cardiovascular-pathology-angiography

Figure 1: Coronary angiography; no significant stenosis was present.

cardiovascular-pathology-akinesis

Figure 2: Left ventriculography shows akinesis of the left ventricular apex.

cardiovascular-pathology-ventricle

Figure 3: Trans thoracic echocardiography shows shunt flow from the left ventricle to the right ventricle.

Results

Median sternotomy was performed. The left ventricle was incised using cardiopulmonary bypass and induced cardiac arrest. A perforation measuring 5 x 5mm was present in the ventricular septum near the apex (Figure 4). The ventricular septum of the perforated region was not fragile, but relatively firm. Two pairs of hemashield patches were attached to the perforated region from the right and left ventricle. Teflon felt strip was applied to close the left ventricle incision. The postoperative course was uneventful.

cardiovascular-pathology-septum

Figure 4: A perforation measuring 5 × 5 mm was present in the ventricular septum near the apex.

Conclusion

Takotsubo cardiomyopathy has a good prognosis and is associated with a higher prevalence in neurologic or psychiatric disorder [1]. The mechanism of TCM-VSP is unclear, but a case of TCM-VSP on pathological examination showed myocardial necrosis in the ruptured region [2]. Ventricular septal perforation is surgically treated by the infarct exclusion technique [3,4]. P atch repair for TCM-VSP can be a viable treatment, because the ventricular septum of the perforated region is not fragile. TCM-VSP is a rare and critical condition that requires optimal treatment and careful monitoring.

Refrences

Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Recommended Journals

Recommended Conferences

  • 9th World Congress and Expo on Immunology
    November 2-3, Atlanta, Georgia, USA
  • 3rd Global Summit on Heart Diseases 
    November 2nd-4th, 2017 Bangkok, Thailand.
  • 22nd World Cardiology Congress
    December 11-12, 2017 Rome Italy

Article Usage

  • Total views: 451
  • [From(publication date):
    November-2016 - Oct 20, 2017]
  • Breakdown by view type
  • HTML page views : 394
  • PDF downloads :57
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords