Sunday, August 02, 2009

Tako-Tsubo par excellence


Stress cardiomyopathy is an increasingly recognised differential diagnosis of an apparent acute coronary syndrome.

A 50 odd year old man with long history of addiction originally from Northland, in the city for 1 week waiting to check into alcohol rehab. He presented to Auckland City Hospital with few hours history of chest pain after giving a speech at the local AA meeting.

Arrival ECG showed some ST elevation in the II, III and aVF. Angiogram within one hour showed no culprit lesion but mid ventricle ballooning.

A few hours later, confined in a side room in CCU, he wanted a smoke. Nurse gave up convincing him and paged the registrar at 0630hrs instead (the feeling of course is if they are up working, so should the lazy registrar). After a few standard exchange the patient then poured his heart out saying he left Northland because his family literally kicked him out because of his addiction troubles, and for the first time this 50 year old man revealed a bit of his secrets which he blames as the cause of his addition at the AA meeting. What follow was of course his heart attack.

His emotional burden, the telling of his secrets, literally caused his heart to be broken.

No comments: