Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Transient left ventricular apical ballooning, "Takotsubo" cardiomyopathy, in an amyotrophic lateral sclerosis patient on long term respiratory support

Maki Mitani, M.D., Itaru Funakawa, M.D. and Kenji Jinnai, M.D.

Department of Neurology, National Hospital Organization Hyogo Chuo National Hospital

A 52-year-old woman developed dysarthria and dysphagia in April 1997, then experienced progressive weakness in her arms and legs several months later, which led to a diagnosis of amyotrophic lateral sclerosis (ALS). In October 1998, the patient was placed on respiratory support and thereafter in a bedridden state. On December 6, 2004, the patient suddenly fell into cardiogenic shock. An echocardiographic examination demonstrated extensive akinesis of the left ventricle together with the hyperkinetic constraction of the cardiac base. The left ventricular akinesis completely returned to normal by December 13. Based on our these results and her clinical course, we made a diagnosis of "Takotsubo" cardiomyopathy. This is the first case reported to have developed this condition in an ALS patient on long term respiratory support. Physicians should be aware of the potential risk of developing "Takotsubo" cardiomyopathy in respirator-dependent ALS patients.

(CLINICA NEUROL, 45: 740|743, 2005)
key words: amyotrophic lateral sclerosis, autonomic nerve dysfunction, "Takotsubo" cardiomyopathy

(Received: 21-Feb-05)