Use of Levosimendan for Cardiogenic Shock in a Patient with the Apical Ballooning Syndrome

Letters2 September 2008Use of Levosimendan for Cardiogenic Shock in a Patient with the Apical Ballooning SyndromeVincenzo De Santis, MD, Domenico Vitale, MD, Luigi Tritapepe, MD, Cesare Greco, MD, and Paolo Pietropaoli, MDVincenzo De Santis, MDFrom Sapienza University of Rome, Rome 00161, Italy., Domenico Vitale, MDFrom Sapienza University of Rome, Rome 00161, Italy., Luigi Tritapepe, MDFrom Sapienza University of Rome, Rome 00161, Italy., Cesare Greco, MDFrom Sapienza University of Rome, Rome 00161, Italy., and Paolo Pietropaoli, MDFrom Sapienza University of Rome, Rome 00161, Italy.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-5-200809020-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: The apical ballooning syndrome (ABS), also known as takotsubo cardiomyopathy and the broken heart syndrome, is an acute cardiac syndrome frequently precipitated by a stressful event. It has a clinical presentation that is indistinguishable from myocardial infarction (1). Patients commonly present with chest pain and dyspnea or with cardiogenic shock (prevalence, 2.4% to 7.4%) and ventricular fibrillation (prevalence, 0.65% to 3.9%) (2). Treatment is nonspecific.Objective: To report a patient with ABS complicated by cardiogenic shock who recovered after intravenous administration of levosimendan.Case Report: A 68-year-old woman with an unremarkable medical history was sent to the emergency department ...References1. Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, et al. Systematic review: transient left ventricular apical ballooning: a syndrome that mimics ST-segment elevation myocardial infarction. Ann Intern Med. 2004;141:858-65. [PMID: 15583228] LinkGoogle Scholar2. Prasad A, Lerman A, Rihal CS. Apical ballooning syndrome (Tako-Tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction. Am Heart J. 2008;155:408-17. [PMID: 18294473] CrossrefMedlineGoogle Scholar3. Wittstein IS, Thiemann DR, Lima JA, Baughman KL, Schulman SP, Gerstenblith G, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005;352:539-48. [PMID: 15703419] CrossrefMedlineGoogle Scholar4. Russ MA, Prondzinsky R, Christoph A, Schlitt A, Buerke U, Söffker G, et al. Hemodynamic improvement following levosimendan treatment in patients with acute myocardial infarction and cardiogenic shock. Crit Care Med. 2007;35:2732-9. [PMID: 17893627] MedlineGoogle Scholar5. Mann DL, Kent RL, Parsons B, Cooper G. Adrenergic effects on the biology of the adult mammalian cardiocyte. Circulation. 1992;85:790-804. [PMID: 1370925] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Vincenzo De Santis, MD; Domenico Vitale, MD; Luigi Tritapepe, MD; Cesare Greco, MD; Paolo Pietropaoli, MDAffiliations: From Sapienza University of Rome, Rome 00161, Italy.Disclosures: None disclosed. 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