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Europace Advance Access published online on February 4, 2009
Europace, doi:10.1093/europace/eup011
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

SHORT COMMUNICATION

A fatal combination in an old lady: Tako-Tsubo cardiomyopathy, long QT syndrome, and cardiac hypertrophy

Horst Wedekind1,*, Joachim G. Müller2, Michael Ribbing1, Paul Skurzewski1, Christoph Bozzetti1, Hans-Joachim Meyer-Krahmer3 and Dirk Böcker1

1 Department of Medicine, Cardiology and Intensive Care Medicine, St Marien-Hospital Hamm, Knappenstrasse 19, 59069 Hamm, Germany; 2 Department of Medicine, Cardiology Unit, Fletcher Allen Health Care, University of Vermont, Burlington, VT, USA; 3 Department of Radiology, St Marien-Hospital Hamm, Hamm, Germany

Tako-Tsubo cardiomyopathy (TT-CM), also called stress-induced cardiomyopathy or transient left ventricular (LV) apical ballooning syndrome, is characterized by transient apical or midventricular LV dysfunction that mimics myocardial infarction, but in the absence of significant coronary artery disease. The onset of TT-CM is typically triggered by an acute medical illness or by intense emotional, psychological, or physical stress. During the acute phase, a disturbed repolarization with QT prolongation in the surface ECG is frequently obvious. Despite the generally good prognosis of TT-CM, severe clinical courses have been reported due to the depressed LV function with cardiogenic shock or malignant tachyarrhythmias. We report an unusual presentation of a patient with TT-CM and recurrent episodes of torsades de pointes tachyarrhythmias. In this patient, we identified pre- and coexisting congenital long QT syndrome and severe cardiac hypertrophy—all of them associated with disturbed myocardial repolarization and predisposed the patient to malignant tachyarrhythmias.

* Corresponding author. Tel: +49 5381 1872306; fax: +49 5381 182302. E-mail address: horst.wedekind{at}marienhospital-hamm.de

Manuscript submitted 27 October 2008. Accepted after revision 12 January 2009.


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Europace, June 1, 2009; 11(6): 697 - 700.
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