Broken heart syndrome in an 83-year-old woman
Ekşi Duran, Nilüfer
Sungur Biteker, Funda
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CitationBiteker, M., Ekşi Duran, N., Gündüz, S., Candan, Ö., Biteker, F. S., Gökdeniz, T., Güler, A. ve Özkan, M. (2008). Broken heart syndrome in an 83-year-old woman. Journal of the American Geriatrics Society. 56(11), s. 2142-2143.
An 83‐year‐old woman was admitted to the emergency department because of severe chest pain that had begun 2 hours before and radiated to the neck and left arm. Except for advanced age, she had no coronary risk factors. Her husband had died that day after 58 years of marriage. On admission, physical examination revealed no pathological findings other than slightly high blood pressure and tachycardia. Her blood pressure was 175/90 mmHg, and heart rate was 110 beats/min. Electrocardiogram showed sinus tachycardia and 2‐mm ST elevation in leads I, aVL, and V2 to V6 (Figure 1A). After being given 300 mg of aspirin and 5,000 U of intravenous heparin the patient was taken to the coronary intensive care unit. Transthoracic echocardiography (TTE), performed in the coronary intensive care unit immediately, revealed apical akinesia, midventricular hypokinesia and basal hyperkinesia of the left ventricle, moderate mitral regurgitation with ejection frequency of 30%. To exclude coronary artery disease, coronary angiography was performed, which revealed noncritical coronary plaques in the left anterior descending and circumflex artery. Ventriculography showed apical and midventricular ballooning with basal hyperkinesia (Figure 1B). Chest pain disappeared spontaneously. Cardiac enzyme and troponin levels were high and reached maximal degrees (creatine kinase, 623 U/L; creatine kinase‐MB, 98 U/L; troponin I, 4.2 μg/L) on the second day. Her hospital course was uneventful. TTE, performed on the seventh day, revealed normal left ventricular systolic function without any segmental wall motion abnormality. Her ejection fraction was 58%, with trace mitral regurgitation. On the seventh day, myocardial perfusion scintigraphy was performed, and there was no sign of ischemia. With these findings, TC was diagnosed, and a consultation with a psychiatrist was recommended. The patient was discharged from the hospital in excellent condition and at a 1‐month follow‐up visit was doing well.
SourceJournal of the American Geriatrics Society
- Makale Koleksiyonu