初回無痙攣電気通電療法直後に無症候性たこつぼ心筋症を発症した1症例

A Case of Asymptomatic Takotsubo Cardiomyopathy Immediately after Initial Modified Electroconvulsive Therapy

要旨

　無痙攣電気通電療法の施行直後にたこつぼ心筋症が発症する瞬間をモニター心電図上のST上昇でとらえることができたまれな症例を経験した。無痙攣電気通電療法後のたこつぼ心筋症の発症症例として，無症状であった点，初回かつ電気刺激5分後という超短期発症という点において非典型的な経過であった。

　A woman in her 70’s was admitted to our hospital to receive initial course of modified electroconvulsive therapy（mECT）for her severe depression. Five minutes after the stimulus of the first mECT, the ST segment became gradually elevated in lead Ⅱ monitor electrocardiogram. The ST-elevation was also observed in Ⅰ, Ⅱ, aVF, V2-6 in 12-lead electrocardiogram. Acute coronary syndrome was excluded by coronary angiography. Left ventricular angiography showed apical akinesis with basal hyperkinesis. According to the Mayo criteria, she was diagnosed with takotsubo cardiomyopathy. The present case was atypical for takotsubo cardiomyopathy following mECT with the aspect of asymptomatic and extreme short onset.