Coronary Spasm and Polymorphic Ventricular Tachycardia One Year After Takotsubo

Stress cardiomyopathy is typically considered to be a disease with a favorable long-term prognosis, with malignant arrhythmias accompanying only the acute phase. We describe a 51-year-old female who presented with palpitations one year after stress cardiomyopathy and complete recovery of apical left...

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Published inMayo Clinic proceedings. Innovations, quality & outcomes Vol. 3; no. 2; pp. 231 - 234
Main Authors Williford, Noah N., Mazur, Alexander, Rhodes, Troy, Demetroulis, Elaine, Gebska, Milena A.
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Inc 01.06.2019
Elsevier
Subjects
Case Report
TTE
VT
ICD
VT, ventricular tachycardia
TTE, transthoracic echocardiogram
ICD, implantable cardioverter-defibrillator
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Summary:Stress cardiomyopathy is typically considered to be a disease with a favorable long-term prognosis, with malignant arrhythmias accompanying only the acute phase. We describe a 51-year-old female who presented with palpitations one year after stress cardiomyopathy and complete recovery of apical left ventricular wall motion. Coronary spasm was strongly suspected based on transient ST-segment elevations followed by sustained polymorphic ventricular tachycardia captured on ambulatory Holter. Contrast injection during coronary angiography reproduced spasm and ventricular arrhythmia that resolved with intracoronary nitroglycerine. The patient was intolerant to nitrates therefore discharged on 2 calcium channel blockers. Shared decision was made to implant cardioverter defibrillator.
ISSN:2542-4548
2542-4548
DOI:10.1016/j.mayocpiqo.2019.01.001