naa a22 4500 510800378 CHVBK 20180411083352.0 cr unu---uuuuu 180411e20130401xx s 000 0 eng 10.1007/s12028-011-9658-9 doi (NATIONALLICENCE)springer-10.1007/s12028-011-9658-9 Cardiomyopathy with Inverted Tako-Tsubo Pattern in the Setting of Subarachnoid Hemorrhage: A Series of Four Cases [Elektronische Daten] [Sana Shoukat, Ahmed Awad, Douglas Nam, Michael Hoskins, Owen Samuels, Jason Higginson, Stephen Clements Jr] Background: Severe subarachnoid hemorrhage may be associated with regional wall motion abnormalities (RWMA) in the absence of epicardial coronary occlusion. The RWMA extends beyond the distribution of a single coronary artery and may present in a typical tako-tsubo cardiomyopathy pattern. Other variants have also been recognized, including an inverted tako-tsubo pattern of severe basal hypokinesis that spares the apex. The mechanism of this cardiomyopathy is not well understood but likely involves catecholamine excess. While classic tako-tsubo cardiomyopathy from emotional stress carries a favorable prognosis, cardiac dysfunction from subarachnoid hemorrhage is a marker of overall poor prognosis. Methods: We collected cases over a period of 4years at a large teaching hospital. The cases represent cardiac dysfunction in the setting of subarachnoid hemorrhage in the unusual distribution of basal hypokinesis with relative sparing of the apex (inverted tako-tsubo pattern). Results: A total of four cases were identified. All cases were female between the ages 43-67years and had echocardiographic evidence of basal hypokinesis after suffering from an intracranial hemorrhage. Conclusions: The typical and inverted patterns may represent a spectrum within the same disease process or distinct clinical entities with dramatically different prognostic implications. Larger studies comparing the two presentations will help elucidate this further. Springer Science+Business Media, LLC, 2012 Subarachnoid hemorrhage nationallicence Tako-tsubo cardiomyopathy nationallicence Inverted tako-tsubo cardiomyopathy nationallicence Shoukat Sana Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut Awad Ahmed Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut Nam Douglas Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut Hoskins Michael Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut Samuels Owen Department of Neurocritical Care, Emory University School of Medicine, Atlanta, Georgia aut Higginson Jason Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut Clements Jr Stephen Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut Neurocritical Care Humana Press Inc 18/2(2013-04-01), 257-260 1541-6933 18:2<257 2013 18 12028 https://doi.org/10.1007/s12028-011-9658-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-011-9658-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shoukat Sana Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut NATIONALLICENCE 700 1- Awad Ahmed Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut NATIONALLICENCE 700 1- Nam Douglas Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut NATIONALLICENCE 700 1- Hoskins Michael Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut NATIONALLICENCE 700 1- Samuels Owen Department of Neurocritical Care, Emory University School of Medicine, Atlanta, Georgia aut NATIONALLICENCE 700 1- Higginson Jason Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut NATIONALLICENCE 700 1- Clements Jr Stephen Division of Cardiology, Emory University School of Medicine, 1365 Clifton Road, NE, 30322, Atlanta, GA, Georgia aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/2(2013-04-01), 257-260 1541-6933 18:2<257 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer