[PDF][PDF] The oldest patient with takotsubo cardiomyopathy

M Budnik, R Piatkowski, J Kochanowski… - Journal of Geriatric …, 2015 - jgc301.com
M Budnik, R Piatkowski, J Kochanowski, R Glowczynska, D Gorko, R Kowalik, A Pietrasik…
Journal of Geriatric Cardiology: JGC, 2015jgc301.com
Takotsubo cardiomyopathy (TTC) is a rare condition that affects mainly aging women.
According to a retrospective review, patients with TTC accounted for approximately 2% of all
the patients with suspected acute coronary syndrome (ACS). A few reports indicated that the
average age of TTC patients was 68 years, although children or young adults may also be
affected. In US and Europe, a number of contemporary TTC studies report that 90% of
patients with TTC are women aged 65–70 years. Meta analysis showed that the age ranged …
Takotsubo cardiomyopathy (TTC) is a rare condition that affects mainly aging women. According to a retrospective review, patients with TTC accounted for approximately 2% of all the patients with suspected acute coronary syndrome (ACS). A few reports indicated that the average age of TTC patients was 68 years, although children or young adults may also be affected. In US and Europe, a number of contemporary TTC studies report that 90% of patients with TTC are women aged 65–70 years. Meta analysis showed that the age ranged from 10 to 89 years.[1] There was also one case study of a 90-year-old patient with TTC―the oldest patient known so far. In that case, the patient died during the course of treatment from severe multi-organ failure.[2] In the present case report, we present a 98-years old woman with TTC admitted to our clinic. A 98-years old patient was admitted to our clinic because of significant chest pain and general weakness accompanied by hypotension that required catecholamine administration with ST-segment elevation in the anterolateral leads in ECG. The patient suffered from hypertension and third stage of chronic kidney disease. Urgent cardiac catheterization and ventriculography confirmed the absence of any critical coronary disease, but also the presence of a typical apical ballooning and midventricular hypokinesis. Troponin I (TnI) at admission was 5.555 ng/mL and creatine kinase soenzyme MB (CK-MB) mass was 14.5 ng/mL. Inflammatory parameters were not elevated, whereas N-terminal pro brain natriuretic peptide (NT-proBNP) concentration was markedly elevated, at 18,623 pg/mL. NT-proBNP/TnI ratio was 3352.48 on the first day and even higher after 24 h, at 7113.36. This markers profile is characteristic of TTC. There is a relatively small increase in creatine kinase and troponin concentrations in relation to the extent of wall motion abnormalities. BNP is always elevated in patients with
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