Takotsubo Cardiomyopathy Associated with Jet-Lag Syndrome in a Taiwanese Elderly Woman: A Case Report and Literatures Review

Chi Sheng Chiou, Nen-Chung Chang, Chun-Ming Shih, Wei Fung Bi, Chun-Yao Huang, Zhi Yang Lai, Mei Shu Lin

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Takotsubo cardiomyopathy (CM) is still very rare in Taiwan. A 74-year-old Taiwanese woman came back from abroad for one week and suffered from a persisting and severe jet lag with sleep disturbance. She had a cold and experienced exacerbated bronchial asthma 3 days before the attack. She presented with sudden onset of chest pain after drinking 3 cups of coffee and taking a sauna for more than one hour. Upon admission, electrocardiogram (ECG) showed ST-segment elevation in leads Ⅱ, Ⅲ aVF, and V3-6 while cardiac enzymes reported minimal elevation. Echocardiogram showed apical ballooning and basal hyperkinesias of the left ventricle (LV) in systole. Coronary angiogram on the second day read normal when ST-segment continued to elevate with ongoing chest pain. Negative T wave developed 3 days later. The ECG abnormality and LV dysfunction completely disappeared 6 months later. We diagnosed the case as Takotsubo CM. The activated myocardial adrenergic nervous system stimulated by acute and marked stress in this patient with more adrenergic innervations distributed in apex of LV might be the trigger for this novel cardiac syndrome.
Original languageEnglish
Pages (from-to)130-141
Number of pages12
Issue number2
Publication statusPublished - 2006



  • Takotsubo cardiomyopathy
  • ampulla cardiomyopathy
  • apical ballooning

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