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20 February 2012

Takotsubo syndrome in a patient after renal transplantation

Beata E. ChrapkoABCDEFG, Andrzej TomaszewskiBCDEF, Andrzej J. JaroszyńskiBCD, Jacek FurmagaBCD, Andrzej WysokińskiB, Sławomir RudzkiB

DOI: 10.12659/MSM.882510

Med Sci Monit 2012; 18(3): CS26-30


Background: Takotsubo syndrome (TTS) is a transient cardiomyopathy of unknown origin, clinically manifesting as acute coronary syndrome (ACS). This syndrome mainly occurs in postmenopausal women and has a temporary relationship with emotional or physical stress.
Case Report: TTS occurred in 46-year-old female patient on the first day after renal transplantation. The predominant symptoms were connected with ACS, performed with low grade troponin elevation and characteristic shape of left ventricle depicted in echocardiography. Taking into consideration the risk of the development of contrast-induced nephropathy, coronary angiography (CA) was delayed; myocardial perfusion scintigraphy and iodine-123 metaiodobenzylguanidine (123I-mIBG) myocardial uptake were performed to confirm the clinical suspicion. Myocardial perfusion scintigraphy (MPS) performed in rest condition showed normal perfusion but myocardial uptake of 123I-mIBG was impaired. Within 6 months after surgery, full recovery of all biochemical and functional parameters of the left ventricle were observed. At that time CA was done, depicting normal coronary arteries.
Conclusions: TTS could be diagnosed by the use of non-nephrotoxic tests – 123I-mIBG myocardial scintigraphy, MPS and echocardiography.

Keywords: Kidney Transplantation - adverse effects, Iodine Radioisotopes, Coronary Angiography, 3-Iodobenzylguanidine, myocardial perfusion imaging, Takotsubo Cardiomyopathy - etiology

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750