Image Based Medical Questions -1
Contents
A Elderly lady of 59 years came to emergency department with complain of chest pain, dyspnea, and syncope. She is non diabetic and there is no history of hypertension. She is under treatment for depression.
- ECG revealed dynamic pattern of electrocardiographic changes -ST-segment elevations in anterior precordial leads.
- Cardiac biomarkers – troponins and CK-MB was mild elevated.
- She was taken for angiogram
- The image of LV angiogram is given below.
- What is the probable diagnosis for the image given below?
Olagoke Akinwande, Yasmin Hamirani and Ashok Chopra, CC BY 2.0 https://creativecommons.org/licenses/by/2.0, via Wikimedia Commons
[A] Pseudoaneurysm of LV
[B] Apical HCM
[C] Takotsubo cardiomyopathy
[D] Ischemic cardiomyopathy
When takotsubo cardiomyopathy presents as ST-elevation acute coronary syndrome or troponin-positive acute coronary syndrome. What is the is the invasive procedure of choice?
[A] PET -CT
[B] MR Angiogram
[C] CT Angiogram
[D] Cardiac catheterization
Takotsubo cardiomyopathy is also known as
- Transient apical ballooning syndrome
- Apical ballooning cardiomyopathy
- Stress-induced cardiomyopathy[stress cardiomyopathy]
- Gebrochenes-Herz syndrome
- Broken-heart syndrome
Takotsubo cardiomyopathy – is a form of non-ischemic cardiomyopathy and predominantly affects post-menopausal women
Types of Takotsubo cardiomyopathy
- Apical type (typical): there is a systolic apical ballooning of the left ventricle [80% of patients]
- Mid-ventricular type hypokinesis
- Basal type hypokinesis
- Focal type hypokinesis – most commonly the anterolateral segment
