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Table 2 Case report review of takotsubo syndrome with pulmonary embolism

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

  1. HR: heart rate; BP: blood pressure; CK: creatine kinase; cTnI: troponin I; cTnT: troponin T; ECG: electrocardiogram; UCG: ultrasonic cardiogram; CAG: coronary angiography; EF: ejection fraction; LMWH: low molecular weight heparin; F: female; DVT: deep vein thrombosis; NA: not available; ACEI: angiotension converting enzyme inhibitors; LV: left ventricule; RV: right ventricle; FEU:fibrinogen equivalent unit; NM: not measured