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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
Sex Risk Factor Presentation HR BP
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
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)
(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
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