Hello again fellow Bloggers! Time for the monthly blogpost you have been waiting for, Rhythm Nation. Enjoy!
90 yo F w/ h/o HTN, HLD, DM, asthma, presenting with 3 hours of acute SOB and mid-sternal, non-radiating chest pain.
V/S: BP: 191/99, HR: 76, RR: 40, O2 99% on RA, Temp: 96.2 F
Exam:
Gen: Resp distress
HEENT: PERRLA, MMM
Neck: + JVD
Cardiac: S1/S2, no MGR
Resp: bilateral rales
Abd: soft NTND
Extrem: no edema
EKG:
Code H was called and patient taken to cath lab. Here is a clip from the cath:
The report showed, in addition to the finding in the above clip, that the coronaries showed non-obstructive CAD.
What is the likely diagnosis?
What on the EKG and the cath suggests this diagnosis?
How do you confirm the diagnosis?
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carmellig
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1 Comment
ablumenberg · October 25, 2015 at 3:35 pm
Takotsubo cardiomyopathy
– Indistinguishable on presentation and on EKG from STEMI, activating code H was correct move. This is not a clinical diagnosis.
– Confirmed by echo and/or cardiac cath. This patient has non occlussive CAD and characteristic “octopus pot” shape on ventriculogram
– http://cdn.lifeinthefastlane.com/wp-content/uploads/2009/11/abd10113_fm-1.jpg