Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neurogenic stunned myocardium (NSM) and Takotsubo cardiomyopathy (TCM) are two syndromes that coexist in the medical literature. They share many common features. We hypothesized that they, in fact, represent the same syndrome. We collected and analyzed case reports of transient left ventricular (LV) dysfunction in neurologic conditions. Cases were compared based on the diagnosis and then based on the pattern of wall motion abnormality. Of 112 cases, 61 were diagnosed as TCM and 37 as NSM, and in 14 cases, the authors used both terms. Overall, the patients with NSM were younger, and the severity of LV systolic dysfunction and timing of recovery was similar, as well as the prevalence of cardiac enzyme elevation. Pulmonary edema on presentation was more prevalent in patients with NSM while chest pain and ST-segment elevation was more common in patients with TCM. While only regional, predominantly apical, wall motion abnormality was described in TCM, some patients in the NSM group had global LV dysfunction. NSM and TCM likely share the same mechanism and pathologic substrate. Their natural course is almost identical. They both likely represent the same syndrome of stress-induced cardiomyopathy. Current definition of stress-induced cardiomyopathy includes only regional wall motion abnormalities. It should be expanded to include all varieties of wall motion abnormalities including global hypokinesis.
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PMID:Neurogenic stunned myocardium and takotsubo cardiomyopathy are the same syndrome: a pooled analysis. 2160 86

Takotsubo cardiomyopathy (TC), also called stress-induced cardiomyopathy, is a rare type of nonischemic cardiomyopathy accompanied by a transient ballooning and akinesis of the left ventricle. It has been reported mainly in the Japanese literature, although awareness is increasing in the United States and Europe. The reason for the increased incidence in postmenopausal women remains unclear, as does why the apex and left ventricular midcavity are commonly affected. The degree of symptom presentation and severity varies widely and is usually accompanied by an unremarkable medical history. The most frequent presentation is left ventricular dysfunction with or without pulmonary edema. Identifying signs and symptoms and its correlation with physical or emotional stress will lead to early diagnosis and intervention. This case report describes a premenopausal woman in whom TC developed in the immediate postoperative period following general anesthesia.
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PMID:Early postoperative Takotsubo cardiomyopathy: a case report. 2175 87

We present a case of a 23 year-old pregnant woman, who underwent a cesarian section due to the risk of eclampsia. The patient developed pulmonary oedema due to severe left ventricular impairement. After the standard treatment and a short period of bromocriptine, the symptoms of the oedema subsided. In order to differentiate between the primary dilated cardiomyopathy and postpartum cardiomyopathy (PPC), the magnetic resonance imaging (MRI) examination was carried out twice at a 3-month interval, and confirmed the diagnosis of PPC. This case report underlines the role of MRI in detection of PPC.
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PMID:[Pulmonary oedema--as first symptom of the postpartum cardiomyopathy. The role of cardiac MRI in diagnostic process]. 2192 6

Stress-induced cardiomyopathy is an acute cardiac syndrome mimicking ST-segment elevation myocardial infarction and is characterised by transient left ventricular dysfunction in the absence of obstructive coronary artery disease. Caesarean delivery is associated with intense emotional and physical stress, which may precipitate stress-induced cardiomyopathy mimicking acute myocardial infarction. We report a case of a woman who was supported with extracorporeal membrane oxygenation for acute heart failure and severe pulmonary oedema, which may have resulted from stress-induced cardiomyopathy in the early postpartum period following caesarean delivery.
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PMID:Extracorporeal membrane oxygenation in a patient with stress-induced cardiomyopathy after caesarean section. 2197 Jan 46

A 90-year-old woman presented with aneurysmal subarachnoid hemorrhage (SAH) corresponding to Hunt and Hess grade II. Acute congestive heart failure and pulmonary edema developed following uneventful surgical clipping. Serial electrocardiography and echocardiography led to a diagnosis of neurogenic stress cardiomyopathy (NSC), also known as tako-tsubo cardiomyopathy. The outcome was favorable after supportive therapy with respiratory management and diuretic administration. Neurosurgeons treating SAH must take into account the various general treatment strategy options on a case by case basis after prompt recognition of NSC.
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PMID:Neurogenic stress cardiomyopathy following aneurysmal subarachnoid hemorrhage in a very elderly patient--case report. 2219 7

A 68-year-old woman was admitted to our hospital due to sudden onset of dyspnea. On admission, electrocardiogram (ECG) showed T-wave inversion and QRS prolongation (120 msec) that were not found in her previous ECG. Chest X-ray showed pulmonary edema and cardiac enlargement. Left ventriculogram showed akinesis of the left ventricle except in the basal region. No significant coronary stenosis was found on angiogram. She was diagnosed as having tako-tsubo cardiomyopathy complicated by QRS prolongation. Intraaortic balloon pumping (IABP) was subsequently initiated for the treatment of acute heart failure. QRS prolongation was resolved immediately after the initiation of IABP, and left ventricular dysfunction was resolved within 9 days. She was discharged 14 days later.
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PMID:Tako-tsubo cardiomyopathy complicated by QRS prolongation. 2229 5

Stress-induced cardiomyopathy (SICM) presenting as an acute myocardial dysfunction is characterized by transient left ventricular wall motion abnormality, which has been known to be associated with excessive catecholamine production caused due to various types of stress. Sympathetic hyperactivity is common during the perioperative period, and reports of SICM occurring during this period have actually increased. We present a case of SICM following negative pressure pulmonary edema due to upper airway obstruction during emergence from anesthesia. Excessive catecholamine release in response to respiratory difficulty could have been the underlying inciting factor.
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PMID:Stress-induced cardiomyopathy after negative pressure pulmonary edema during emergence from anesthesia -A case report-. 2232 59

Patients with poor-grade subarachnoid hemorrhage (SAH) are often complicated with acute cardiopulmonary dysfunctions, particularly neurogenic pulmonary edema (NPE) and takotsubo-like cardiomyopathy (TCM). This study retrospectively investigated the incidence, demographics, clinical characteristics, and outcomes of patients with SAH complicated with both NPE and TCM (NPE-TCM). The effects of aneurysm location and other clinical variables on the incidence of NPE-TCM were also investigated. Among 234 SAH patients treated during 5-year period, 16 (7%) presented with NPE, and transthoracic ultrasonography revealed that 14 of these 16 patients (88%) also had TCM. All 14 patients with NPE-TCM had poor-grade SAH (World Federation of Neurosurgical Societies grades IV and V). Ruptured posterior circulation aneurysm was predictive of NPE-TCM, but other clinical variables were not. Eight of the 14 patients with NPE-TCM could undergo treatment for ruptured aneurysm. Long-term outcomes were favorable in 5 of the 8 patients. Grade IV SAH patients had significantly better outcomes than grade V patients. TCM develops frequently in SAH patients presenting with NPE, and transthoracic ultrasonography should be conducted routinely in that population. Patients with ruptured posterior circulation aneurysm may have elevated risk of developing NPE-TCM. Endovascular obliteration of the aneurysm may be preferable to open surgery, but the optimal treatment modality needs to be evaluated further. Considering the limited number of SAH patients complicated with NPE-TCM, a multi-center cooperative study may be required.
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PMID:Subarachnoid hemorrhage complicated with neurogenic pulmonary edema and takotsubo-like cardiomyopathy. 2236 83

A 29-year-old female patient presented with shock and dyspnea due to heart failure and pulmonary edema. Echocardiography indicated excessive contraction limited to the left ventricular apex and akinesis of the basal and middle ventricle, which were confirmed by emergency left ventriculography. The finding was diagnostic of inverted Takotsubo cardiomyopathy. An abdominal computed tomography scan showed a tumor in the left adrenal gland with a central low-density area, and the plasma and urinary catecholamines were strikingly elevated. Taken together, these findings suggested the presence of a hemorrhagic pheochromocytoma. A myocardial biopsy in the very acute stage on the day of admission revealed neutrophilic infiltration and contraction-band necrosis, which was indistinguishable from the previously reported pathology in the acute phase of idiopathic Takotsubo cardiomyopathy without pheochromocytoma. The diagnosis of pheochromocytoma in this case was confirmed 7 weeks later by surgical removal of the left adrenal gland with massive hemorrhage at the center of the pheochromocytoma. The marked similarity of the endomyocardial pathology between this case and cases with idiopathic Takotsubo cardiomyopathy strongly points to catecholamine excess as a common causality for Takotsubo cardiomyopathy with or without pheochromocytoma.
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PMID:Endomyocardial biopsy in a patient with hemorrhagic pheochromocytoma presenting as inverted Takotsubo cardiomyopathy. 2247 28

The number of pregnant women with cardiac disease is increasing with improvements in technology. In addition, more people are part of the national health insurance plan. However, there are few reports concerning the best method for anesthesia and mode of delivery in these high-risk patients. We report a 29-year-old woman scheduled for a planned caesarean section, who had a history of severe peripartum cardiomyopathy requiring extracorporeal membrane oxygenation in a previous pregnancy. The patient had regular prenatal care in our obstetric clinic. At 29 weeks' gestation, she developed severe dyspnea. A chest radiograph revealed bilateral pulmonary edema and 2-dimensional echocardiography showed a global hypokinesis and severe valve regurgitation with left ventricular ejection fraction of 41.2%. She had an emergency caesarean section and a cardiovascular surgeon was consulted to stand-by. Anesthesia was induced by ketamine 25 mg, midazolam 2.5 mg and rocuronium 50 mg for rapid intubation. The patient tolerated the procedure well and was extubated on postoperative day 1. She was discharged one week after surgery. Postoperatively, the patient was followed in the obstetric and cardiovascular surgery outpatient departments and at 5 months after surgery she was in good condition without any complaints.
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PMID:Anesthetic management of a repeat cesarean section in a parturient with severe peripartum cardiomyopathy requiring ECMO in a previous pregnancy: a case report. 2249 Apr 55


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