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1、Casereportspart1Case1AcuteIschemicCardiomyopathyafterExtremeEmotionalStressinaChildABSTRACTIschemiccardiomyopathyisrareinchildren.Itisusuallycausedbycongenitalanomaliesofcoronaryarteries,coronaryanomaliesaftercoronaryarterytransfer,orKawasakidisease.Inre
2、centyears,anewcardiacsyndrome—named"Tako-Tsubocardiomyopathy"fortheparticularshapeoftheendsystolicventricle—hasbeendescribedinadults.Intheabsenceofcoronaryarteryobstruction,itmimicsacutemyocardialinfarctionwithchestpainandtypicalelectrocardiographychange
3、s.Emotionalorphysicalstressusuallyprecedesthiscardiomyopathy.Atpresent,thisentityhasonlybeendescribedinadults,withastrongpredominanceinpostmenopausalwomen.Wereportacaseofacuteischemiccardiomyopathyafterextremestressinachildthatmaysharethesamepathophysiol
4、ogy.VentriculographicAssessmentofCardiacFunctionandMRIAssessmentofMyocardialViabilityatAdmissioninaPatientwithStressCardiomyopathy.Contrast-enhancedventriculographyduringdiastole,inPanelA,andsystole,inPanelB,demonstratesapicalandmidventricularakinesis,wi
5、threlativesparingofthebaseoftheheart(arrow).InPanelC,MRIinthelong-axisviewrevealsthattheakineticregionsseenonventriculographyaredarkandhypoenhanced,consistentwiththepresenceofviablemyocardium.PanelD,whichispresentedforpurposesofcomparison,showshyperenhan
6、cement(arrow),indicativeofnecrosisanddecreasedviability,afteranacuteanteriormyocardialinfarctionA20-year-oldmanwhoservedasamidshipmanpresentedtoourcardiologyclinicafterachestradiographthathadbeenobtainedaspartofthephysicalexaminationformilitary-officerco
7、mmissioningwasfoundtobeabnormal.Hesaidhehadnosymptoms,andtheresultsofaphysicalexaminationwerenormal.Case2A20-year-oldmanwhoservedasamidshipmanpresentedtoourcardiologyclinicafterachestradiographthathadbeenobtainedaspartofthephysicalexaminationformilitary-
8、officercommissioningwasfoundtobeabnormal.Hesaidhehadnosymptoms,andtheresultsofaphysicalexaminationwerenormal.Case2A20-year-oldmanwhoservedasamidshipmanpresentedtoourcardiologyclinicafterachestradiographthathadbeenobtaineda
