Abstract
We experienced a case with left ventricular systolic dysfunction persisting for at least 1 year after the onset of Takotsubo cardiomyopathy, which had manifested 7 days after surgery for subarachnoid hemorrhage. A 67-year-old woman, who had developed a subarachnoid hemorrhage due to a ruptured anterior communicating artery aneurysm, underwent aneurysm-clipping surgery on the day of the hemorrhage. Seven days post-operatively, she complained of sudden chest discomfort and developed acute heart failure. The patient was diagnosed with Takotsubo cardiomyopathy based on electrocardiography, transthoracic echocardiography, and coronary angiography, and was considered to concomitantly have experienced an acute myocardial infarction due to coronary spasm based on high levels of cardiac enzymes and a positive hyperventilation test. The subarachnoid hemorrhage resolved uneventfully, but the findings of Takotsubo cardiomyopathy remained unchanged for at least 1 year without any improvement of either the impaired left ventricular wall motion or cardiac function. The reason for impaired left ventricular wall motion and cardiac dysfunction persisting for at least 1 year in this patient with Takotsubo cardiomyopathy was considered to be the concomitant acute myocardial infarction due to coronary spasm.
