000			02617nam a22003257a 4500
008			190621s20132013 xxu||||| |||| 00| 0 eng d
022			_a2000-9666
040			_aOvid MEDLINE(R)
099			_a23882408
245			_aA case of apical ballooning syndrome in a male with status asthmaticus; highlighting the role of B2 agonists in the pathophysiology of a reversible cardiomyopathy.
251			_aJournal of Community Hospital Internal Medicine Perspectives. 3(2), 2013.
252			_aJ Community Hosp Intern Med Perspect. 3(2), 2013.
253			_aJournal of community hospital internal medicine perspectives
260			_c2013
260			_fFY2013
265			_sepublish
266			_d2019-06-21
520			_aApical ballooning syndrome (ABS), also known as Takotsubo cardiomyopathy, was first reported by Dote and colleagues in Japanese literature in 1991 in a review of five cases. Case series have highlighted the association of severe psychological stressors as the major precipitating factors of this syndrome. Status Epilepticus and Sub-Arachnoid hemorrhage are also now established independent etiologies for this phenomenon in patients without coronary artery disease. We report a case of reversible apical ventricular dysfunction in a 50-year-old male presenting with status asthmaticus who quickly underwent intubation. Following this, he had ST elevations in precordial leads with mild cardiac enzyme leak. Subsequent cardiac catheterization revealed a left ventricular ejection fraction of 25-30% with apical aneurismal segment. No obstructive disease was observed. Three days later there was marked clinical improvement; the patient was extubated and repeat echocardiography revealed a remarkable return to normal ventricular size and systolic function. Our case demonstrates that excess use of beta-agonists may be a potential risk factor for ABS and raises the possibility of cathecholamine cardiotoxicity being mediated via beta-receptors. Furthermore, it also negates the propensity of apical ballooning so far reported only in women with respiratory distress without confounding emotional stressors.
546			_aEnglish
650			_aPubMed-not-MEDLINE -- Not indexed
651			_aMedstar Union Memorial Hospital
657			_aCase Reports
700			_aAgarunov, Lev
700			_aBuescher, Philip
700			_aSalahuddin, Farah F
700			_aSloane, Peter
790			_aAgarunov L, Buescher P, Salahuddin FF, Sloane P, Sreeramoju D
856			_uhttps://dx.doi.org/10.3402/jchimp.v3i2.20530 _zhttps://dx.doi.org/10.3402/jchimp.v3i2.20530
942			_cART _dArticle
999			_c4382 _d4382