Clinical case of mid-ventricular variant of takotsubo syndrome against the background of exacerbation of bronchial asthma

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Abstract

Research in recent decades has expanded our understanding of the pathogenesis and clinical and laboratory data arising from takotsubo syndrome (TS; previously this condition was called takotsubo cardiomyopathy, stress cardiomyopathy), but despite this, its timely diagnosis in practical healthcare causes difficulties. Often these patients are managed according to the protocol of acute coronary syndrome with a “working” diagnosis of myocardial infarction (MI) without obstructive lesions of the coronary arteries; but according to modern concepts, TS is not included in the MI concept. The article describes a clinical observation of secondary TS that developed against the background of bronchial asthma exacerbation. A feature of this case is the development of the mid-ventricular variant of the disease, which occurs approximately 5.5 times less frequently than the typical apical form.

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About the authors

D. S. Evdokimov

North-Western State Medical University n.a. I.I. Mechnikov

Email: bykovaelenag@mail.ru
ORCID iD: 0000-0002-3107-1691
Russian Federation, St. Petersburg

Elena G. Bykova

North-Western State Medical University n.a. I.I. Mechnikov

Author for correspondence.
Email: bykovaelenag@mail.ru
ORCID iD: 0000-0001-9902-2338

Cand. Sci. (Med.), Associate Professor at the Department of Faculty Therapy

Russian Federation, St. Petersburg

E. D. Resnyanskaya

North-Western State Medical University n.a. I.I. Mechnikov

Email: bykovaelenag@mail.ru
ORCID iD: 0000-0001-7889-3679
Russian Federation, St. Petersburg

S. A. Boldueva

North-Western State Medical University n.a. I.I. Mechnikov

Email: bykovaelenag@mail.ru
ORCID iD: 0000-0002-1898-084X
Russian Federation, St. Petersburg

References

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. ECG upon admission

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3. Fig. 2. Coronary angiography: the right coronary artery and its branches

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4. Fig. 3. Coronary angiography: the trunk of the left coronary artery and its branches

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5. Fig. 4. Ventriculography of LV diastole

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6. Fig. 5. Ventriculography of LV systole (arrows indicate areas of violation of local LV contractility)

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7. Fig. 6. T1 DIR pulse sequence along the short LV axis at the level of the basal segments

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8. Fig. 7. Pulse sequence T1 DIR four-chamber axis of the heart

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9. Fig. 8. The pulse sequence of TIR along the short LV axis at the level of the basal segments

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