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J Korean Soc Emerg Med > Volume 28(4); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(4): 380-386.
A Case of Ventricular Septal Rupture in Stress Cardiomyopathy
Heajin Chung
Department of Emergency Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
Correspondence  Heajin Chung ,Tel: 02-710-3278, Fax: 02-709-9083, Email: chjin516@gmail.com,
Received: June 13, 2017; Revised: June 14, 2017   Accepted: July 12, 2017.  Published online: August 31, 2017.
ABSTRACT
Stress cardiomyopathy (SCMP) is a reversible heart disease, commonly accompanied by emotional or physical stress. Early clinical features are similar to those of acute myocardial infarction, such as acute chest symptoms, ST-segment elevation on electrocardiography, and cardiac biomarkers elevation. However, there is usually no evidence of significant coronary obstruction on a coronary angiogram. Moreover, ventricular dysfunction with regional wall motion abnormalities does not correlate with a single vascular territory. The typical type of SCMP is apical wall motion abnormality with an apical ballooning pattern, and various types of SCMP have recently been reported. Generally, cardiac dysfunction or abnormal wall motion is improved within several weeks, and the prognosis of SCMP is generally good. Thus, the mainstay of the treatment is largely conservative. However, there are some serious complications during the acute phase. In particular, cardiac rupture is a rare but serious structural complication associated with high mortality. In this manner, SCMP could potentially be life threatening during the acute phase, despite it generally being a benign disease in most cases. Early recognition of this complication, appropriate medical therapy, and surgical intervention are required to improve recovery and survival. Here, I report a case of an 83-year-old female patient with SCMP complicated by ventricular septal rupture.
Key words: Stress, Cardiomyopathies, Ventricular septal rupture, Myocardial infarction
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