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01-02-2008 | CASE REPORT

Takotsubo cardiomyopathy in a patient with postural tachycardia syndrome

Author: Ramesh K. Khurana, MD

Published in: Clinical Autonomic Research | Issue 1/2008

Abstract

A patient with postural tachycardia syndrome (POTS) developed takotsubo cardiomyopathy while undergoing elective surgery. Based on experimental data, we hypothesize that POTS may have predisposed our patient to this disorder and suggest possible modifications in management.

Arora S, Alfayoumi F, Srinivasan V (2003) Transient left ventricular apical ballooning after cocaine use: is catecholamine cardiotoxicity the pathologic link? Mayo Clin Proc 81:829–832CrossRef

Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, Rihal CS (2004) Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infraction. Ann Intern Med 141:858–865PubMed

Ebert TJ (2004) Autonomic effects of anesthesia. In: Robertson D, Biaggioni I, Burnstock G, Low PA (eds). Primer on the autonomic nervous system, second edition. Elsevier, Amsterdam, pp 172–175CrossRef

Goldstein DS, Holmes C, Frank SM, Dendi R, Cannon RO III, Sharabi Y, Esler MD, Eisenhofer G (2002) Cardiac sympathetic dysautonomia in chronic orthostatic intolerance syndromes. Circulation 106:2358–2365PubMedCrossRef

Grubb BP, Kanjwal Y, Kosinski DJ (2006) The postural tachycardia syndrome: a concise guide to diagnosis and management. J Cardiovasc Electrophysiol 17:108–112PubMedCrossRef

Haensch CA, Lerch H, Jigalin A, Schlemmer H, Isenmann S (2007) Cardiac denervation in a case of postural tachycardia syndrome. Clin Auton Res. DOI: 10.1007/s10286-007-0442-z

Hoeldtke RD, Bryner KD, Hoeldtke ME, Hobbs G (2006) Treatment of postural tachycardia syndrome: a comparison of octreotide and midodrine. Clin Auton Res 16:390–395PubMedCrossRef

Jacob G, Biaggioni I (1999) Idiopathic orthostatic intolerance and postural tachycardia syndromes. Am J Med Sci 317:88–101PubMedCrossRef

Kawano H, Okada R, Yano K (2003) Histological study on the distribution of autonomic nerves in the human heart. Heart Vessels 18:32–39PubMedCrossRef

10.

Kern KB (2002) Postresuscitation myocardial dysfunction. Cardiol Clin 20(i):89–101PubMedCrossRef

11.

Khurana RK (1995) Orthostatic intolerance and orthostatic tachycardia: a heterogeneous disorder. Clin Auton Res 5:12–18PubMedCrossRef

12.

Khurana RK (2006) Experimental induction of panic-like symptoms in patients with postural tachycardia syndrome. Clin Auton Res 16:371–377PubMedCrossRef

13.

Khurana RK, Chang PM (2001) Isoproterenol test: clinical utility in patients with orthostatic intolerance and orthostatic tachycardia (abstract). Neurology 56:A425

14.

Khurana RK, Nicholas EM (1996) Head-up tilt table test: how far and how long? Clin Auton Res 6:335–341PubMedCrossRef

15.

Khurana RK, Wu WM (2001) The Valsalva’s maneuver: a literature review and personal observations. Auton Rev 5:61–70

16.

Khurana RK, Yao MD (2000) Orthostatic intolerance with orthostatic hypertension: clinical and autonomic profile (abstract). Neurology 54:A161

17.

Kyama M, Tsuchehashi K, Shinshi Y, Hase M, Nakata T, Ooiwa H, Abiru M, Hikita N, Adachi T, Shoji T, Fujice Y, Shimamoto K (2002) Effect of intravenous propranolol on left ventricular apical ballooning without coronary artery stenosis (ampulla cardiomyopathy) – three cases. Circ J 66:1181–1184CrossRef

18.

Mori H, Ishikawa S. Kojima S, Hayashi J, Watanabe Y, Hoffman JI, Okino H (1993) Increased responsiveness of left ventricular apical myocardium to adrenergic stimuli. Cardiovasc Res 27:192–198PubMedCrossRef

19.

Nemeroff CB, Owens MJ (2004) Pharmacologic differences among the SSRI’s: focus on monoamine transporters and the HPA axis. CNS Spectr 9(6 suppl 4):23–31PubMed

20.

Pierpont GL, DeMaster EG, Cohn JN (1984) Regional differences in adrenergic function within the left ventricle. Am J Physiol 246:H824–H829PubMed

21.

Robertson D (1999) The epidemic of orthostatic tachycardia and orthostatic intolerance. Am J Med Sci 317:75–77PubMedCrossRef

22.

Schroeder C, Tank J, Boschmann M, Diedrich A, Sharma AM, Biaggioni I, Luft FC, Jordan J (2002) Selective norephinephrine reuptake inhibition as a human model of orthostatic intolerance. Circulation 105:347–353PubMedCrossRef

23.

Shomali ME, Khurana RK (2005) Central adrenal insufficiency in patients with orthostatic intolerance and orthostatic tachycardia (abstract). Clin Auton Res 15:347

24.

Spes C, Knape A, Mudra H (2006) Recurrent tako-tsubo-like left ventricular dysfunction (apical ballooning) in a patient with pheochromocytoma – a case report. Clin Res Cardiol 95:307–311PubMedCrossRef

25.

Taneja I, Raj SR, Robertson D (2005) Pressor effect of modafinil in the postural orthostatic tachycardia syndrome (abstract). Clin Auton Res 15:348

26.

Tremblay P, Blier P (2006) Catecholaminergic strategies for the treatment of major depression. Cur Drug Targets 7:149–158CrossRef

27.

Ueyama T, Kasamatsu K, Hano T, Yamamoto K, Tsuruo Y, Nishio I (2002) Emotional stress induces transient left ventricular hypocontraction in the rat via activation of cardiac adrenoceptors—a possible animal model of “tako-tsubo” cardiomyopathy. Circ J 66:712–713PubMedCrossRef

28.

Wittstein IS, Thiemann DR, Lima JA, Baughman KL, Schulman SP, Gerstenblith G, Wu KC, Rade JJ, Bivalacqua TJ, Champion HC (2005) Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med 352:539–548PubMedCrossRef

Title: Takotsubo cardiomyopathy in a patient with postural tachycardia syndrome
Author: Ramesh K. Khurana, MD
Publication date: 01-02-2008
Publisher: D. Steinkopff-Verlag
Published in: Clinical Autonomic Research / Issue 1/2008
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI: https://doi.org/10.1007/s10286-007-0444-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Takotsubo cardiomyopathy in a patient with postural tachycardia syndrome

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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