PT  - JOURNAL ARTICLE
AU  - Hidetsugu Maekawa
AU  - Hiromu Hadeishi
TI  - Takotsubo cardiomyopathy following subarachnoid haemorrhage
AID  - 10.1136/practneurol-2013-000629
DP  - 2014 Aug 01
TA  - Practical Neurology
PG  - 252--255
VI  - 14
IP  - 4
4099  - http://pn.bmj.com/content/14/4/252.short
4100  - http://pn.bmj.com/content/14/4/252.full
SO  - Pract Neurol2014 Aug 01; 14
AB  - A 67-year-old woman was admitted with aneurysmal subarachnoid haemorrhage and a 12-lead ECG showed ST segment elevation. Transthoracic echocardiography confirmed akinesis of the left ventricular mid-apical segment, with an ejection fraction of 26%, features characteristic of takotsubo cardiomyopathy. Five days later, we identified thrombus in the apex of the left ventricle. Sixteen days after onset, the thrombus had disappeared and wall motion improved (ejection fraction 58%) without evidence of cardioembolism. Takotsubo cardiomyopathy is a cause of cardiac dysfunction after stroke, including SAH. It is characterised by transiently depressed contractile function of the left mid and apical ventricle, without obstructive coronary artery disease. Clinicians should suspect takotsubo cardiomyopathy in patients with subarachnoid haemorrhage who have an ECG abnormality. Echocardiography is needed to detect the distinctive regional wall motion abnormality. Despite its severity in the acute phase, takotsubo cardiomyopathy is self-limiting and its management is conservative.