This case highlights that ventricular septal perforation, a critical complication typically associated with acute myocardial infarction, can rarely occur in patients with takotsubo cardiomyopathy.
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Ventricular septal perforation may complicate takotsubo cardiomyopathy with rapid shock; single case leaves open true incidence and management.
An 84-year-old woman was admitted with anorexia and because the serum cardiac markers, electrocardiogram and echocardiography suggested acute myocardial infarction she underwent emergency cardiac catheterization. Coronary angiography revealed no significant coronary artery stenosis, but left ventriculography revealed akinesis of the left ventricular apex with shunt flow to the right ventricle. The diagnosis was a rare case of takotsubo cardiomyopathy complicated by ventricular septal perforation. The patient died of cardiogenic shock on the day of admission day.
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Sakai et al. (2005) studied this question.
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