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Document Details :
Title: Een 72-jarige vrouw met thoracale pijn na een verkeersongeval
Author(s): HENDRICKX I, HENDRICKX I, SCOTT B
Journal: Tijdschrift voor Geneeskunde
Volume: 68 Issue: 10 Date: 2012
A 72-year-old woman with thoracic pain after a traffic accident
A 72-year-old woman with native coronary disease presented with acute thoracic pain and dyspnea after a traffic accident with frontal collision. The clinical examination was normal. The electrocardiogram (ECG) showed sinus rhythm with ST-elevation and biphasic T-waves in leads V2-V5. An urgent coronarography revealed native coronary disease, which could not explain the ECG-changes. Left chamber angiography disclosed apical akinesia and hyperdynamic contractile basal segments. The ejection fraction (EF) was calculated at 50%. The thoracic pain was relieved by medication and the ECG showed evolution to negative T-waves and prolonged QT-intervals. A control echocardiography indicated fast stabilization and normalization of the LV-function (EF: 71%). Because of the exclusion of an acute myocardial infarction and contusio cordis, the diagnosis of Takotsubo cardiomyopathy was made.
This case-report shows the importance to consider the possibility of a Takotsubo cardiomyopathy when a patient with known coronary disease presents with an acute coronary syndrome.