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J Korean Soc Emerg Med > Volume 19(6); 2008 > Article
Journal of The Korean Society of Emergency Medicine 2008;19(6): 777-782.
Tako-tsubo Syndrome after Acute Traumatic Subdural Hematoma Mimicking Acute ST Elevation Myocardial Infarction
Il Kug Choi, Seong Beom Oh, Kyeong Ho Kang, Young Jin Lee, Ik Pom Kim, Hyuk Sang Koh
Department of Emergency Medicine, College of Medicine, Dankook University, Cheonan, Korea. holytiger@hanmail.net
Electrocardiographic changes frequently occur after severe physical or emotional stress. Such changes can mimic acute ST-segment elevation myocardial infarction with elevated serum cardiac-specific markers (CK-MB, Troponin I), segmental wall motion abnormalities, and myocardial dysfunction. Several reports, however, have found that coronary angiography revealed no significant stenosis. We present a 70-yearold female with a traumatic subdural hematoma testing positive for cardiac enzymes, and ECG changes suggestive of acute ST-segment elevation myocardial infarction. Such a case, however, fits the diagnostic parameters of Tako-tsubo cardiomyopathy, or Tako-tsubo syndrome; even though its etiology, pathophysiology, diagnosis, and treatment remain uncertain. Tako-tsubo syndrome is characterized by a distinctive form of systolic dysfunction that predominantly affects the distal LV chamber, but a favorable outcome with appropriate medical therapy is expected. Because of its unusual nature and favorable prognosis, it is clear that Tako-tsubo syndrome is an important affliction that should be recognized by any emergency department.
Key words: Takotsubo cardiomyopathy, Subdural hematoma, Traumatic, Myocardial infarction
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