Takotsubo cardiomyopathy and giant r wave syndrome mimicking acute myocardial infarction: A case report

Medicine
Yong WangJianliang Ma

Abstract

The clinical features of Takotsubo cardiomyopathy largely overlap with those of acute myocardial infarction, especially in the presence of ST-segment elevation on the initial electrocardiogram. Giant R wave syndrome has mainly been observed in the hyperacute phase of acute myocardial infarction. In this study, we report a unique case of Takotsubo cardiomyopathy that caused giant R wave syndrome. A 71-year-old woman was transferred to hospital with new onset chest pain. An initial electrocardiogram showed ST-segment elevation in the inferior wall and anterior wall leads. Her initial cardiac troponin I levels were elevated. Acute myocardial infarction was suspected and the patient underwent emergent cardiac catheterization. A coronary angiography showed no overt stenosis in the coronary artery. After 2 hours, her chest pain disappeared and an electrocardiogram revealed that the ST segment had decreased markedly. However, on day 3, an electrocardiogram of the V1-V6 leads revealed the formation of giant R wave syndrome: giant R waves merging with the markedly elevated ST segments and the obliteration of S waves. Cardiac echocardiography showed hypokinetic apical mid-segments and hyperkinetic basal segments of the left ventricle, lo...Continue Reading

References

Aug 19, 2009·Annual Review of Medicine·Yoshihiro J AkashiTakashi Ueyama
Jul 13, 2011·Journal of Medical Case Reports·Ana Testa-FernándezCarlos Gonzalez-Juanatey
Jan 28, 2014·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Zhaolong XuYuhong Li
Aug 19, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Dawn C Scantlebury, Abhiram Prasad
Sep 4, 2015·The New England Journal of Medicine·Christian TemplinThomas F Lüscher
Jul 15, 2016·Journal of the American Heart Association·Antonio H FrangiehUNKNOWN InterTAK Collaborators

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Methods Mentioned

BETA
percutaneous transluminal coronary angioplasty

Software Mentioned

GRWS

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