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

Research output: Contribution to journalArticle

Abstract

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
Journal台灣老年醫學雜誌
Volume2
Issue number2
Publication statusPublished - 2006

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Jet Lag Syndrome
Takotsubo Cardiomyopathy
Heart Ventricles
Chest Pain
Adrenergic Agents
Electrocardiography
Steam Bath
Hyperkinesis
Systole
Coffee
Taiwan
Nervous System
Drinking
Angiography
Sleep
Asthma
Enzymes

Keywords

  • Takotsubo cardiomyopathy
  • ampulla cardiomyopathy
  • apical ballooning

Cite this

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title = "Takotsubo Cardiomyopathy Associated with Jet-Lag Syndrome in a Taiwanese Elderly Woman: A Case Report and Literatures Review",
abstract = "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.",
keywords = "Takotsubo cardiomyopathy, ampulla cardiomyopathy, apical ballooning",
author = "Chiou, {Chi Sheng} and Nen-Chung Chang and Chun-Ming Shih and Bi, {Wei Fung} and Chun-Yao Huang and Lai, {Zhi Yang} and Lin, {Mei Shu}",
year = "2006",
language = "English",
volume = "2",
pages = "130--141",
journal = "台灣老年醫學雜誌",
issn = "1817-2784",
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T2 - A Case Report and Literatures Review

AU - Chiou, Chi Sheng

AU - Chang, Nen-Chung

AU - Shih, Chun-Ming

AU - Bi, Wei Fung

AU - Huang, Chun-Yao

AU - Lai, Zhi Yang

AU - Lin, Mei Shu

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N2 - 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.

AB - 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.

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