Can a pneumothorax break your heart?

  • Stylianos Mavridis Department Vascular and Thoracic Surgery, Ernst von Bergmann Clinic, Potsdam
  • Hans-Georg Gnauk Department Vascular and Thoracic Surgery, Ernst von Bergmann Clinic, Potsdam
  • Silvio Horn Department Vascular and Thoracic Surgery, Ernst von Bergmann Clinic, Potsdam
  • Peter Adeberg Department Vascular and Thoracic Surgery, Ernst von Bergmann Clinic, Potsdam
  • Martina Schumacher Department Vascular and Thoracic Surgery, Ernst von Bergmann Clinic, Potsdam
  • Roland H. Wagner Department Vascular and Thoracic Surgery, Ernst von Bergmann Clinic, Potsdam
Keywords: apical ballooning, spontaneous pneumothorax, tako-tsubo cardiomyopathy, thoracoscopic, tube thoracostomy
Abstract viewed: 1583 times
PDF downloaded: 811 times

Abstract

Takotsubo cardiomyopathy or apical ballooning is a condition characterized by transitory left ventricular dysfunction, affecting commonly postmenopausal females after foregoing acute emotional or physical stress. We report a case of a 63 year old female presenting with severe dyspnea and right-sided secondary spontaneous pneumothorax, initially treated with tube thoracostomy. Despite the fact that pneumothorax resolved, shortness of breath persisted and due to ST-segment elevation and increased Troponin I levels, she was admitted to cardiac catheterization. A significant coronary stenosis was ruled out and the diagnosis of a Takotsubo cardiomyopathy was established. Electrocardiographic findings were normalized within three days and attributable to prolonged air leakage. A thoracoscopic apex resection followed by a partial parietal pleurectomy was performed. Although Takotsubo cardiomyopathy is a rare syndrome, it should always be considered as a potential cardiac complication of a pneumothorax.

Downloads

Download data is not yet available.

Author Biography

Roland H. Wagner, Department Vascular and Thoracic Surgery, Ernst von Bergmann Clinic, Potsdam

Roland H Wagner MD, PhD

Head of Department

References

  1. Sousa C, Neves J, Sa N, Goncalves F, Oliveira J, Reis E: 3. Spontaneous pneumothorax: a 5-year experience. J Clin Med Res. 2011;3(3):111-7. http://dx.doi.org/10.4021/jocmr560w

  2. Weissberg D, Rafaely Y. Pneumothorax: experience with 1,999 patients. Chest. 2000;117(5):1279-85. http://dx.doi.org/10.1378/chest.117.5.1279

  3. Kim SJ, Lee HS, Kim HS, Shin HS, Lee JW, Kim K-II, et al. Outcome of video-assisted thoracoscopic surgery for spontaneous secondary pneumothorax. Koren J Thorac Cardiovasc Surg. 2011;44(3);225-8. http://dx.doi.org/10.5090/kjtcs.2011.44.3.225

  4. Mavridis S, Gnauk HG, Schumacher M, Wagner RH. Spontaneous pneumothorax complicating lung emphysema. So, what's the catch?. Med J Indones. 2013;22(1):54-6. http://dx.doi.org/10.13181/mji.v22i1.514

  5. Nef HM, Möllmann H, Elsässer A. Takotsubo cardiomyopathy (apical ballooning). Heart. 2007;93:1309-15. http://dx.doi.org/10.1136/hrt.2006.101675

  6. Waldenborg M, Soholat M, Kähäri A, Emilsson K, Fröbert O. Multidisciplinary assessment of takotsubo cardiomyopathy: a prospective case study. BMC Cardiovasc Disord. 2011;9:11-4 http://dx.doi.org/10.1186/1471-2261-11-14

  7. Kurisu S, Ishibashi K, Kato Y, Mitsuba N, Dohi Y, Nishioka K, Kihara Y: Tako tsubo cardiomyopathy complicated by QRS prolongation. Intern Med. 2012;51(3):291-4. http://dx.doi.org/10.2169/internalmedicine.51.6292

  8. Chia PL, Foo D. Tako tsubo cardiomyopathy precipitated bei pheochromocytoma crisis. Cardiology Journal. 2011;18(5):564-7. http://dx.doi.org/10.5603/CJ.2011.0015

  9. Steinhäuslin CA, Cuttat JF. 12. Spontaneous pneumothorax. A complication of lung cancer?. Chest. 1985;88(5):709-13. http://dx.doi.org/10.1378/chest.88.5.709

  10. Akashi YJ, Sakakibara M, Miyake F. Reversible left ventricular dysfunction "takotsubo" cardiomyopathy associated with pneumothorax. Heart. 2002;87(2):e1. http://dx.doi.org/10.1136/heart.87.2.e1

  11. Villablanca PA, Sukhal S, Ansari A, Mohammed D. Acute gastritis-induced Takotsubo's cardiomyopathy. Clinical Case Reports. 2013;1(2):91-5. http://dx.doi.org/10.1002/ccr3.32

  12. Ha JH, Lee H, Park YJ, Kang HH, Lee SH, Moon HS. Takotsubo cardiomyopathy caused by pulmonary tuberculosis: a case report. Tuberc Respir Dis (Seoul). 2014;77(1):24-7. http://dx.doi.org/10.4046/trd.2014.77.1.24

Published
2015-03-23
How to Cite
1.
Mavridis S, Gnauk H-G, Horn S, Adeberg P, Schumacher M, Wagner RH. Can a pneumothorax break your heart?. Med J Indones [Internet]. 2015Mar.23 [cited 2024Oct.4];24(1):55-8. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/1179
Section
Case Report/Series