Monday, August 15, 2011

Of Broken Hearts and Octopi

A lady came in today with chest pain. She was breathing a little heavy and when I was placing EKG leads on her chest, I asked her about her pain and whether she had had it before. "Yes," she said, "last month, I was here because I had a terrible argument. I was hospitalized and something similar is happening . I had another argument today just now."
"What did they diagnose you with?"
"Something called stress-induced cardiomyopathy."

I repeated this to the attending, who looked up the previous file. "Oh, this is that Japanese syndrome," she said excitedly.

Takotsubo is a rare cardiac pathology that occurs when certain people get very upset. In break-ups, or job losses, or deaths of relatives, these people exhibit real EKG changes and heightened troponin levels (measurement of cardiac muscle damage). The left ventricle loses a lot of its normal function and looks like a diving octopus.
Luckily, this time my patient was not quite as worked up. Her heart did not exhibit the massive damage it had the last time she was here. I just thought this was a very cool case, so I had to share. :-) I am such a dork.

Maybe next time I feel that twisting in my chest when I get really upset, I should get it checked out- maybe there's an octopus in there...

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