A Case Report of "Takotsubo" Type Cardiomyophaty During Upper Digestive Endoscopy.
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Accession number;03A0197686
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| Title;A Case Report of "Takotsubo" Type Cardiomyophaty During Upper Digestive Endoscopy. |
| Author;
AKASHI RYUKICHI
(Kumamoto-Shi Ishikai, Kumamoto Chiiki Iryo Senta)
OGUSHI MASAMICHI
(Kumamoto-Shi Ishikai, Kumamoto Chiiki Iryo Senta)
YOSHIDA MOTOKI
(Kumamoto-Shi Ishikai, Kumamoto Chiiki Iryo Senta)
SAGARA KATSURO
(Kumamotochiikiiryose Naika)
MISUMI KAZUHIKO
(Misumiiin)
MIYAGI NAOTO
(Misumiiin)
NODA KATSUO
(Misumiiin)
OSHIMA SHUICHI
(Misumiiin)
SAITO TARO
(Kumamotochuobyoin Junkankinaika)
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Journal Title;Gastroenterol Endosc
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Journal Code:G0608B
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ISSN:0387-1207
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VOL.45;NO.3;PAGE.253-259(2003)
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| Figure&Table&Reference;FIG.5, TBL.1, REF.34 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Myocardial infarction is a serious complication during digestive endoscopy. Recently, "takotsubo" type cardiomyophaty has been reported as mimic myocardial infarction. We experienced this type of cardiomyophaty during upper digestive endoscopy in a 74-year old woman and could observe changes of symptoms and signs at the onset under vital sign monitoring. "Takotsubo" type cardiomyopahty has been defined as reversible left ventricle dysfunction with ST elevation in some lead of ECG and reported that the reduced cardial function returns to normal within several weeks. Patients with cardiomyophaty are usually misdiagnosed as acute myocardial infarction through ECG findings. The causes of "takotsubo" type cardiomyopahty are uncertain, but it is reported that there is more frequently in women with more than 60 year of age, and it is assumed that stress is a major trigger for the onset of this type cardiomyopahty. Stress such as esophagogastroduodenoscopy (EGD) induces an unstable autonomic nervous condition. During EGD, sympathetic nerve are generally in tension, but parasympathetic nerve become tense only in the early period of EGD. During insersion of the scope from the pharynx into the esophagus and from the lower esophagus to the cardia of the stomach, sympathetic nerves are usually activated, which induces tachycardia of the heart. In this case, however, insersion of the scope causes bradycardia, which indicates parasympathetic nerve activation. Unstable condition of autonomic nervous system caused by this stress might be a key role of onset of "takotsubo" type cardiomyopahty in this case. Because there is a risk of myoardial infarction or myoardial infarction-like state, as this type cardiomyopahty in the case reported here, we recommended vital sign monitoring during digestive endoscopy. (author abst.) |
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