Atrio‐ventricular block and takotsubo syndrome: A review illustrated with two case reports

Figures

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  FIGURE 1. Twelve‐lead electrocardiogram (ECG) reveals high degree of AV‐block (A). TTE shows akinesia in the middle segments of the LV causing mid‐ventricular ballooning (B, diastole and C, systole). LCA and RCA are normal (D and E). Left ventriculography during diastole (F) and systole (G) confirms the echocardiographic findings of left mid‐ventricular ballooning consistent with mid‐ventricular pattern of TS

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  FIGURE 2. Follow‐up with TTE 3 months after the admission shows regress of TS and normalization of LVEF (A, diastole and B, systole). Endocardial ECG from the pacemaker interrogation one year later, shows persistent AV‐Block III (C)

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  FIGURE 3. Twelve‐lead ECG reveals high degree AV‐block (A). Contrast TTE shows clear left mid‐ventricular ballooning (B, diastole and C, systole), a pattern consistent with TS

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  FIGURE 4. LCA (A) is dominant and normal; RCA (B) is hypoplastic and normal. Left ventriculography during diastole (C) and systole (D) shows left mid‐ventricular ballooning (D, white Asterix) consistent with mid‐ventricular pattern of TS. CMR imaging 6 days later showed improvement of LVEF (E, diastole and F, systole) but still mild hypokinesis in the middle segments of the left ventricle (F, white Asterix). There was no late gadolinium enhancement (LGE) in the left ventricular wall (G)

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  FIGURE 5. Follow‐up TTE 3 months later after the admission showing regress of TS and normalization of LVEF (A, diastole and B, systole). ECG from the pacemaker interrogation 3.5 years later showing restoration of sinus rhythm (C)