Manabu Moriya

Ventricular Fibrillation in a Patient with Prominent J Wave in the Inferior and Lateral Electrocardiographic Leads After Gastrostomy

We describe the case of a 39‐year‐old man who experienced a ventricular fibrillation storm related to a prominent J wave in the inferior and lateral electrocardiographic leads on the day after gastrostomy. The J wave slowly decreased after amiodarone therapy (400 mg/day) was started, and ventricular fibrillation disappeared.

Left cervical aortic arch associated with aortic aneurysm, aortic coarctation, and branch artery aneurysm--a case report and review.

Cervical aortic arch (CAA) is a rare congenital aortic anomaly. Although, in CAA, other cardio vascular abnormalities including aortic aneurysm and aortic coarctation are occasionally accom panied, coexistence of those 2 aortic abnormalities on the same patient is rare, and moreover, association of the aneurysm of branching artery has not been reported. The authors present here the first patient with CAA who had both an aneurysm and a coarctation in the aortic arch, and further, another aneurysm in the left subclavian artery. Clinical characteristics of CAA with either aortic aneurysm or aortic coarctation are reviewed.

A case of Takotsubo cardiomyopathy that was confirmed by cardiac catheterization at all three times of onset

Takotsubo cardiomyopathy (TTC) is a cardiomyopathy associated with emotional and physiological stress which can be recurrent. We report a case of recurrent TTC (total 3 times) induced by emotional stress, which was diagnosed accurately by coronary angiography (CAG) and left ventriculography (LVG). A 77-year-old female was referred to our institute because of stomach ache, nausea, dizziness, and vomiting. She had developed TTC associated with emotional stress twice, and she took an angiotensin receptor blocker for preventing recurrence. She was admitted for treatment of electrolyte imbalance. After the admission, she suddenly suffered from chest pain with ST segment elevation in II, III, aVF, V3, V4, V5, and V6 leads in electrocardiography. Emergency CAG showed normal coronary arteries, while LVG revealed apical akinesia and basal hyperkinesia. These findings were compatible with TTC. Follow-up ultrasonic cardiogram showed left ventricular contractile normalization in a week. She was discharged in 22 days. A few cases of repeated recurrence have been reported, but they were not diagnosed by cardiac catheterization. In the present case, 3 episodes of TTC were all diagnosed in CAG and LVG. We suggest that antianxiety drugs have potential to prevent the recurrence of TTC in a case induced by emotional stress. <Learning objective: Takotsubo cardiomyopathy (TTC) is a cardiomyopathy associated with emotional and physiological stress which can be recurrent. A few cases of repeated recurrence have been reported, but they were not diagnosed by cardiac catheterization. We report a case of recurrent TTC (total 3 times) induced by emotional stress, which was diagnosed accurately by coronary angiography and left ventriculography.>.