Article: TAKOTSUBO SYNDROME AND CORONARY ARTERY FISTULA: CASE REPORT AND LITERATURE REVIEW.
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
2023 Volume 51, Issue 1, Page(s) 88–94
Abstract: Takotsubo syndrome (TTS) has been reported in various clinical conditions. Coronary artery fistula (CAF) is diagnosed in 0.2- 0.4% of patients undergoing coronary angiography. Pathologic communication between coronary artery (e.g., left anterior ... ...
| Abstract | Takotsubo syndrome (TTS) has been reported in various clinical conditions. Coronary artery fistula (CAF) is diagnosed in 0.2- 0.4% of patients undergoing coronary angiography. Pathologic communication between coronary artery (e.g., left anterior descending coronary artery - LAD) and cardiac chambers (e.g., left ventricle - LV) is cameral type of CAF which particularly predispose to myocardial ischemia due to a steal syndrome. Eight cases of coexistent TTS and CAF have been reported so far; in 6 of them LAD cameral fistulas drained LV, in 2 others communications between coronary arteries and pulmonary artery were found. The authors describe a case of a 75-year-old female, admitted due to chest pain and dyspnea. Her clinical picture with ST-segment elevation in ECG, moderately increased troponin I and apical ballooning in echocardiography, was more typical for TTS than for myocardial infarction; besides that, color doppler imaging was suggestive of multiple CAF to LV. Coronary angiography showed communication between all (normal) coronary arteries and LV. Throughout the conservative therapy, first, an improvement and then normalization of LV function were observed after 2 and 6 days, respectively. Chest x-ray and computed tomography revealed mediastinal tumor (eventually diagnosed as lung cancer). Cardiac magnetic resonance performed after one month did not show late gadolinium enhancement. During the course of 24 months follow-up, she was taking bisoprolol and ramipril and her cardiologic state remained stable, even during chemotherapy and radiotherapy. The authors collected the clinical data of all 9 cases with concomitant TTS and CAF. Specific TTS triggering factors/predisposing conditions were present in all patients, which has indicated that coexistence of TTS and CAF is rather coincidental. |
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| MeSH term(s) | Humans ; Female ; Aged ; Takotsubo Cardiomyopathy/diagnosis ; Takotsubo Cardiomyopathy/diagnostic imaging ; Contrast Media ; Gadolinium ; Coronary Artery Disease/complications ; Coronary Artery Disease/diagnostic imaging ; Fistula/complications |
| Chemical Substances | Contrast Media ; Gadolinium (AU0V1LM3JT) |
| Language | English |
| Publishing date | 2023-03-24 |
| Publishing country | Poland |
| Document type | Review ; Case Reports ; Journal Article |
| ZDB-ID | 1388406-2 |
| ISSN | 1426-9686 |
| ISSN | 1426-9686 |
| DOI | 10.36740/Merkur202301112 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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