Abstract
An 84-year-old woman with a nosebleeds was transported to our hospital in an ambulance. We checked her vital signs and found an ST segment elevation in lead II on electrocardiography. She did not have chest pain at presentation, and we packed her right nasal cavity with gauze soaked in epinephrine. A 12-lead electrocardiography revealed ST segment elevations in leads II, III, aVf, and V3-V6. She complained of mild chest pain in the ambulance, and her condition was diagnosed as acute myocardial infarction. Coronary angiography revealed no obstructing lesions, and left ventriculography revealed apical ballooning of the left ventricle. On the basis of these findings, the condition was diagnosed as Takotsubo cardiomyopathy (TCM). TCM is a cardiac condition with clinical symptoms similar to those of myocardial infarction and is usually associated with emotional stress. This is the first report of TCM in an elderly woman with a nosebleeds. The findings of this case indicate the importance of routine examination, including electrocardiography, in the evaluation of the condition of a patient with common complaints.
