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François Marquis - One of the best experts on this subject based on the ideXlab platform.
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Can takotsubo cardiomyopathy be diagnosed by autopsy? Report of a presumed case presenting as cardiac Rupture
BMC Clinical Pathology, 2017Co-Authors: Andrew Mitchell, François MarquisAbstract:Background Takostsubo (stress) cardiomyopathy (TC) is a clinical syndrome featuring transient left ventricular dysfunction and wall-motion abnormalities, usually following emotional or physical stress. The diagnosis of TC depends on fulfillment of multiple clinical criteria. Although the pathogenesis has not been firmly established, Myocardial cathecholamine toxicity is thought to represent a primary mechanism. The vast majority of patients with TC survive. However, a rare cause of death in TC is Myocardial Rupture. All documented cases of Rupture have followed known, recently diagnosed or suspected TC. However, in this report we propose that an initial diagnosis of TC with Myocardial Rupture can be made by autopsy when supported by a compelling clinical history and appropriate histologic changes in the myocardium. Case presentation An 82 year-old female underwent elective craniotomy for a recently discovered craniopharyngioma. The surgery was uneventful; the initial postoperative course featured diabetes insipidus and delirium. With no prior warning, on the third postoperative day she was found unresponsive in bed. Two prolonged cardiopulmonary resuscitations were successful, however, during a third arrest maneuvers were stopped at the request of the family. An autopsy was conducted which revealed hemopericardium due to cardiac Rupture. Coronary artery atherosclerosis, valve disease, and renal and extra-renal pheochromocytoma were absent. Microscopy of the myocardium showed a recent, localized, transmural Myocardial infarction and diffuse changes (all four ventricles) typical of cathecholamine cardiomyopathy. The findings were considered compatible with TC with secondary Myocardial Rupture. Conclusion An initial diagnosis of TC with Myocardial Rupture can be reasonably made by autopsy in the context of an appropriate clinical history and the presence of the characteristic microscopic features of cathecholamine excess in the myocardium.
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Can takotsubo cardiomyopathy be diagnosed by autopsy? Report of a presumed case presenting as cardiac Rupture.
BMC clinical pathology, 2017Co-Authors: Andrew Mitchell, François MarquisAbstract:Takostsubo (stress) cardiomyopathy (TC) is a clinical syndrome featuring transient left ventricular dysfunction and wall-motion abnormalities, usually following emotional or physical stress. The diagnosis of TC depends on fulfillment of multiple clinical criteria. Although the pathogenesis has not been firmly established, Myocardial cathecholamine toxicity is thought to represent a primary mechanism. The vast majority of patients with TC survive. However, a rare cause of death in TC is Myocardial Rupture. All documented cases of Rupture have followed known, recently diagnosed or suspected TC. However, in this report we propose that an initial diagnosis of TC with Myocardial Rupture can be made by autopsy when supported by a compelling clinical history and appropriate histologic changes in the myocardium. An 82 year-old female underwent elective craniotomy for a recently discovered craniopharyngioma. The surgery was uneventful; the initial postoperative course featured diabetes insipidus and delirium. With no prior warning, on the third postoperative day she was found unresponsive in bed. Two prolonged cardiopulmonary resuscitations were successful, however, during a third arrest maneuvers were stopped at the request of the family. An autopsy was conducted which revealed hemopericardium due to cardiac Rupture. Coronary artery atherosclerosis, valve disease, and renal and extra-renal pheochromocytoma were absent. Microscopy of the myocardium showed a recent, localized, transmural Myocardial infarction and diffuse changes (all four ventricles) typical of cathecholamine cardiomyopathy. The findings were considered compatible with TC with secondary Myocardial Rupture. An initial diagnosis of TC with Myocardial Rupture can be reasonably made by autopsy in the context of an appropriate clinical history and the presence of the characteristic microscopic features of cathecholamine excess in the myocardium.
Andrew Mitchell - One of the best experts on this subject based on the ideXlab platform.
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Can takotsubo cardiomyopathy be diagnosed by autopsy? Report of a presumed case presenting as cardiac Rupture
BMC Clinical Pathology, 2017Co-Authors: Andrew Mitchell, François MarquisAbstract:Background Takostsubo (stress) cardiomyopathy (TC) is a clinical syndrome featuring transient left ventricular dysfunction and wall-motion abnormalities, usually following emotional or physical stress. The diagnosis of TC depends on fulfillment of multiple clinical criteria. Although the pathogenesis has not been firmly established, Myocardial cathecholamine toxicity is thought to represent a primary mechanism. The vast majority of patients with TC survive. However, a rare cause of death in TC is Myocardial Rupture. All documented cases of Rupture have followed known, recently diagnosed or suspected TC. However, in this report we propose that an initial diagnosis of TC with Myocardial Rupture can be made by autopsy when supported by a compelling clinical history and appropriate histologic changes in the myocardium. Case presentation An 82 year-old female underwent elective craniotomy for a recently discovered craniopharyngioma. The surgery was uneventful; the initial postoperative course featured diabetes insipidus and delirium. With no prior warning, on the third postoperative day she was found unresponsive in bed. Two prolonged cardiopulmonary resuscitations were successful, however, during a third arrest maneuvers were stopped at the request of the family. An autopsy was conducted which revealed hemopericardium due to cardiac Rupture. Coronary artery atherosclerosis, valve disease, and renal and extra-renal pheochromocytoma were absent. Microscopy of the myocardium showed a recent, localized, transmural Myocardial infarction and diffuse changes (all four ventricles) typical of cathecholamine cardiomyopathy. The findings were considered compatible with TC with secondary Myocardial Rupture. Conclusion An initial diagnosis of TC with Myocardial Rupture can be reasonably made by autopsy in the context of an appropriate clinical history and the presence of the characteristic microscopic features of cathecholamine excess in the myocardium.
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Can takotsubo cardiomyopathy be diagnosed by autopsy? Report of a presumed case presenting as cardiac Rupture.
BMC clinical pathology, 2017Co-Authors: Andrew Mitchell, François MarquisAbstract:Takostsubo (stress) cardiomyopathy (TC) is a clinical syndrome featuring transient left ventricular dysfunction and wall-motion abnormalities, usually following emotional or physical stress. The diagnosis of TC depends on fulfillment of multiple clinical criteria. Although the pathogenesis has not been firmly established, Myocardial cathecholamine toxicity is thought to represent a primary mechanism. The vast majority of patients with TC survive. However, a rare cause of death in TC is Myocardial Rupture. All documented cases of Rupture have followed known, recently diagnosed or suspected TC. However, in this report we propose that an initial diagnosis of TC with Myocardial Rupture can be made by autopsy when supported by a compelling clinical history and appropriate histologic changes in the myocardium. An 82 year-old female underwent elective craniotomy for a recently discovered craniopharyngioma. The surgery was uneventful; the initial postoperative course featured diabetes insipidus and delirium. With no prior warning, on the third postoperative day she was found unresponsive in bed. Two prolonged cardiopulmonary resuscitations were successful, however, during a third arrest maneuvers were stopped at the request of the family. An autopsy was conducted which revealed hemopericardium due to cardiac Rupture. Coronary artery atherosclerosis, valve disease, and renal and extra-renal pheochromocytoma were absent. Microscopy of the myocardium showed a recent, localized, transmural Myocardial infarction and diffuse changes (all four ventricles) typical of cathecholamine cardiomyopathy. The findings were considered compatible with TC with secondary Myocardial Rupture. An initial diagnosis of TC with Myocardial Rupture can be reasonably made by autopsy in the context of an appropriate clinical history and the presence of the characteristic microscopic features of cathecholamine excess in the myocardium.
Paolo Biglioli - One of the best experts on this subject based on the ideXlab platform.
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Straddling endoventricular pericardial patch in prevention of type I Myocardial Rupture.
The Annals of thoracic surgery, 1993Co-Authors: Vincenzo Arena, Francesco Alamanni, Alberto Repossini, Silvia Di Matteo, Carlo Antona, Paolo BiglioliAbstract:Type I Myocardial Rupture due to atrioventricular discontinuity in the region of the posterior mitral annulus is a fearsome and nearly unpredictable complication of mitral valve replacement. We report a case of a 49-year-old patient who had been operated on for mitral valve replacement. The posterior mitral leaflet had heavy calcifications embedded through the annulus in the posterior ventricular wall. After removal of calcifications we avoided the risk of Myocardial Rupture by suturing a straddling pericardial patch on the atrioventricular junction. The operation resulted in complete recovery.
Vincenzo Arena - One of the best experts on this subject based on the ideXlab platform.
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Straddling endoventricular pericardial patch in prevention of type I Myocardial Rupture.
The Annals of thoracic surgery, 1993Co-Authors: Vincenzo Arena, Francesco Alamanni, Alberto Repossini, Silvia Di Matteo, Carlo Antona, Paolo BiglioliAbstract:Type I Myocardial Rupture due to atrioventricular discontinuity in the region of the posterior mitral annulus is a fearsome and nearly unpredictable complication of mitral valve replacement. We report a case of a 49-year-old patient who had been operated on for mitral valve replacement. The posterior mitral leaflet had heavy calcifications embedded through the annulus in the posterior ventricular wall. After removal of calcifications we avoided the risk of Myocardial Rupture by suturing a straddling pericardial patch on the atrioventricular junction. The operation resulted in complete recovery.
Rainer Von Essen - One of the best experts on this subject based on the ideXlab platform.
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Silent Myocardial Rupture in a patient with diabetes and Addison's disease
International journal of cardiology, 1995Co-Authors: Ralf Ostermaier, Michael Roth, Rainer Von EssenAbstract:We present a case of left ventricular Rupture and formation of a pseudoaneurysm after silent Myocardial infarction in a patient with Schmidt syndrome (polyglandular deficiency syndrome including Addison's disease, lymphocytic thyroiditis and diabetes mellitus). This case illustrates the possibility of Myocardial Rupture without hemodynamic collapse and a possible role of chronic steroid substitution.
