Delayed diagnosis of subarachnoid hemorrhage associated with Tako-tsubo cardiomyopathy.

Boes M et al. Delayed Diagnosis of Subarachnoid Hemorrhage ... Cen Eur Neurosurg 2011; 72: 49 – 51 Delayed Diagnosis of Subarachnoid Hemorrhage Associated with Tako-Tsubo Cardiomyopathy Discussion & Tako-tsubo cardiomyopathy is a recently described acute cardiac syndrome characterized by transient systolic dysfunction. Main criteria for tako-tsubo cardiomyopathy are: a) transient apical and midventricular dyskinesis that extends beyond the distribution of a single coronary artery; b) the absence of signifi cant coronary artery disease or acute plaque rupture on coronary angiography; and c) electrocardiographic evidence of new ST elevation or T-wave inversion. The cause of tako-tsubo cardiomyopathy is unknown, but most cases seem to be related to emotional (33 – 45 % ) and / or physical stress (17 – 22 % ) [10] . There is a strong predominance of postmenopausal women [3] . Precise epidemiological data are not yet available, but serial case studies from Japan revealed a incidence of 1.2 – Introduction & Tako-tsubo cardiomyopathy or “ apical ballooning ” was fi rst described in Japan in 1990 by Satoh et al. [7] The syndrome is characterized by transient left ventricular dysfunction resulting from severe physical or emotional stress. This report describes a 64-year-old woman who underwent CPR (cardiopulmonary resuscitation) because of severe cardiac failure due to tako-tsubo cardiomyopathy. A subarachnoid hemorrhage (SAH) from a ruptured anterior communicating aneurysm was diagnosed as the underlying cause seven days later.