From: Takotsubo syndrome with pulmonary embolism: a case report and literature review
Year | Age (Years) | Sex | Risk Factor | Presentation | HR | BP (mmHg) | D-Dimer | CK | CK-MB | cTnI | cTnT | ECG | UCG | CAG | Left Ventriculogram | Thrombus Position | EF | Treatment | Recover Time and Follow-up | Reference |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
2011 | 79 | F | DVT | pain in left lower extremity and shortness of breath | NA | NA | NA | NA | NA | NA | 0.52 (0–0.03 ng/ml) | non-specific T-wave changes | akinetic apex, anterior and inferior septum | NA | NA | right pulmonary artery branches to the lingula and middle lobe (CT) | 45% | heparin, ACEI, β- blockers | normal (follw-up after 6 months) | [9] |
2011 | 68 | F | DVT | right lower extremity pain and mild dyspnea during a gastroenterology exam | NA | NA | NA | NA | NA | 0.95 (mildly elevated) | NA | poor R-wave progression with no evidence of ST elevation in the precordial leads. | global hypokinesis and apical ballooning | normal | NA | right middle lobe pulmonary artery (CTPA) | 20% | diuretics, ACEI, β- blockers | several days | [10] |
2012 | 65 | F | pyelonephritis, no DVT | flank pain, vomiting and profuse perspiration | 90 | 80/50 | NA | 1548 (50–228 μg/l) | 23.1 (0–3.8 ng/ml) | NA | 2.36 (0–0.1 ng/ml) | ST elevation in D1, aVL, V1-V3 | apical and anterior hypokinesia | normal | akinesis of the ventricular apex | cephalic and posterior-basal segments of the left lung (lung perfusion scintigraphy) | 35% | enoxaparin | several days | [11] |
2013 | 38 | F | fracture | chest discomforts, arrhythmia and shortness of breath after surgery | 75 | 90/60 | 1572 (0–243 ng/mL) | NA | 27 (0–3.6 ng/mL) | 5.3 (0–0.1 ng/mL) | NA | ST depression in V3-V5 | hypokinesia of mid/base segments of LV with hypercontraction of apical segments | no obstructive atherosclerotic diseases | NA | right lower lobe pulmonary artery, anterior and posterior basal segment arteries (CT) | 47% | heparin, β-blockers and diuretics | normal (follw-up after 3 months) | [12] |
2015 | 61 | F | DVT | acute hypoxic respiratory failure | 122 | 141/77 | NA | 2647 (elevated) | 14.7 (elevated) | 0.05 (elevated) | NA | ST elevation in anteroseptal leads | dilated RV and severe RV systolic dysfunction | normal coronary anatomy without obstruction | apical ballooning | emboli in the left and right main pulmonary arteries with extension into the upper and lower lobe branches (CT) | < 55% | heparin, clopidogrel, tPA, LMWH,warfarin | several days | [13] |
2016 | 77 | F | long-haul flight | dyspnea on exertion, orthopnea, and precordial chest tightness | 83 | 92/58 | 4583 (FEU, normal < 750 μg/L) | NA | NA | NA | NA | anterolateral T-wave inversion | akinesia of LV apex | NA | NA | right segmental lower lobe artery (CTPA) | 48% | LMWH, warfarin, bisoprolol, candesartan, aspirin, furosemide, spironolactone | normal (follow-up after 6 weeks) | [14] |
– | 86 | F | DVT | chest tightness, shortness of breath and back pain | 82 | 100/76 | 12 (normal < 0.55 ug/ml) | 133 (0–200 IU/L) | 6.54 (0–4.99 ng/ml) | 0.041 (0–0.02 ng/ml) | NM | Q-waves in leads I, aVL and V2- V9, ST elevation in leads V2-V9, biphasic T-waves in V2-V9 and negative T-wave in V1 | hypokinesia of the LV anterior, anteroseptal, anterolateral wall and apex | stable coronary plaques | NM | bilateral pulmonary arteries (CT) | 36% | enoxaparin, rivaroxaban, aspirin, clopidogrel, β- blockers and diuretics | normal (follow-up after 3 months) | this case |