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A Case of Asymptomatic Takotsubo Cardiomyopathy with Intraventricular Thrombus Associated with Epileptic Seizure Masamitsu Yaguchi 1 , Hisa Yaguchi 1 , Noriko Takahashi 2 1Department of Neurology,Shinoda General Hospital 2Department of Cardiology,Shinoda General Hospital Keyword: takotsubo cardiomyopathy , apical ballooning , neurogenic stunned myocardium , epilepsy , seizure pp.897-900
Published Date 2011/8/1
DOI https://doi.org/10.11477/mf.1416100982
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Abstract

 A 69-year-old woman was admitted to our department for consciousness disturbance with generalized clonic seizure. She had a history of complex partial seizure with automatism 3 years previously, but had not received any antiepileptic drug therapy. On admission, she was unconscious with a Japan Coma Scale of 200. Physical examination demonstrated a blood pressure of 162/90mmHg and pulse of 126beats/min. Neurological examination did not detect any focal findings. Four hours later, she was conscious and antiepileptic drug therapy was initiated. Twenty-six hours post admission, ECG monitoring showed giant T-wave inversion, but cardiac symptoms were absent. Echocardiography showed apical ballooning of the left ventricle. Echocardiography on day 6 demonstrated a thrombus at the apex of the left ventricle. Anticoagulant therapy was started immediately. Echocardiography on day 14 showed that the left ventricular apical asynergy had completely resolved, and the thrombus had disappeared.

 Takotsubo cardiomyopathy could be a complication of epilepsy. It occurs most often soon after epileptic seizure, rarely occurs with a time lag and is asymptomatic as in the present case. ECG monitoring after epileptic seizure is useful for prompt detection and treatment of takotsubo cardiomyopathy.

(Received: December 14,2010,Accepted: December 17,2010)


Copyright © 2011, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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