Two Cases of Takotsubo Cardiomyopathy in Patients with Anorexia Nervosa

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  • Nishihara Tomoe
    Department of Psychosomatic Medicine, Kyushu University Hospital
  • Takakura Shu
    Department of Psychosomatic Medicine, Kyushu University Hospital
  • Hata Tomokazu
    Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University
  • Yokoyama Hiroaki
    Department of Psychosomatic Medicine, Kyushu University Hospital
  • Gondo Motoharu
    Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University
  • Morita Chihiro
    Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University
  • Kawai Keisuke
    Department of Psychosomatic Medicine, Kyushu University Hospital
  • Takii Masato
    Department of Psychosomatic Medicine, Kyushu University Hospital
  • Sudo Nobuyuki
    Department of Psychosomatic Medicine, Kyushu University Hospital:Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University

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Other Title
  • たこつぼ型心筋症を合併した神経性食欲不振症の2例
  • 症例研究 たこつぼ型心筋症を合併した神経性食欲不振症の2例
  • ショウレイ ケンキュウ タコツボカタ シンキンショウ オ ガッペイ シタ シンケイセイ ショクヨク フシンショウ ノ 2レイ

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Abstract

Takotsubo cardiomyopathy (TC) is characterized by transient hypokinesis, akinesis, or dyskinesis in the left ventricular (LV) mid segments with or without apical involvement, provoked by an episode of emotional or physical stress. Recently, TC has been reported to be a severe complication in patients with AN. In this paper, we present two cases of young female AN patients who had suffered from TC. Case 1 : A 18-year-old female patient who had two-year history of AN, was admitted to the emergency room of our hospital. Her body mass index (BMI) was 9.2 kg/m^2. Her blood glucose level was below detection limits. Her electrocardiogram (ECG) showed ST-segment elevation in anterior and lateral leads, accompanied by apical akinesis, a typical finding of "TC" in echocardiography (UCG). Case 2 : A 32-year-old female patient who had two-year history of severe AN, was transferred to our department because of her BMI was 9.0 kg/m^2, and hypoglycemia and hypotension were manifested. She showed inverted T in precardial leads of her ECG, concomitant with severe LV dysfunction in UCG. These two patients were diagnosed as suffering from TC, because their ECG and UCG findings were not correlated with the distribution of a single major coronary artery They failed to show any elevation of blood CK levels during their clinical courses. We recommend routinely performing cardiac evaluation to detect TC in patients with severe AN.

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