This ECG is taken from an elderly woman with chest pressure radiating to left shoulder for 30 minutes. She also complained of nausea with vomiting. Her family offered a history of unspecified cardiac disease, hypertension, hypercholesterolemia, and dementia.
The ECG shows ST elevation in Leads I and aVL, with reciprocal ST depression in Leads III and aVF. ST segments have an abnormally flat shape in Leads aVL, II, III, aVF, V5 and V6.
She was admitted to the hospital and sent to the cath lab. Her arteries were found to be clear, and Takotsubo cardiomyopathy was diagnosed. See also.
Our thanks to Lew Steinberg and Palm Beach Gardens Fire Rescue for donating this interesting ECG.
This image is courtesy of Dr. Stasinos Theodorou of the Limassol Cardiology practice. It may be used free of charge and free of copyright for educational purposes. For any commercial use, please contact Dr. Theodorou at the Limassol Cardiology practice.
This ventriculogram shows the typical apical ballooning of the left ventricle during Takotsubo myocardiopathy. This serious condition can be caused by extreme stress, such as in the death of a loved one, or prolonged high stress levels. The ECG will usually show ST elevations indicating an anterior wall M.I., but the angiogram will show no arterial occlusions. Takotsubo myopathy causes a sudden onset of congestive heart failure. It is transient, and those who survive it generally recover fully. For an excellent and complete discussion of Broken-Heart Syndrome,
