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Case Reports
. 2018 Jun 29:2018:bcr2018225044.
doi: 10.1136/bcr-2018-225044.

Reversible cardiac dysfunction in long-standing hypertension may be global variant of stress cardiomyopathy

Anand Chockalingam  1 , Senthil A Kumar  1
Affiliations
Case Reports

Reversible cardiac dysfunction in long-standing hypertension may be global variant of stress cardiomyopathy

Anand Chockalingam et al. BMJ Case Rep. .

Abstract

An adult man with long-standing poorly controlled cardiac risk factors presented with acute decompensated heart failure (ADHF). Echocardiogram, cardiac MRI and catheterisation suggested idiopathic dilated cardiomyopathy, severe systolic dysfunction, ejection fraction 25% with global left ventricular (LV) dilation and apical thrombus. He responded well to diuretics and gradual uptitration of lisinopril and carvedilol. Follow-up echocardiogram in 2 months demonstrated complete recovery of systolic function, normalisation of LV size and shape with severe LV hypertrophy. This presentation is potentially a global variant of stress cardiomyopathy with recovery of LV function, highlighting the importance of appropriate imaging, catheterisation and clinical monitoring in patients with ADHF.

Keywords: heart failure; hypertension.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Parasternal long-axis view demonstrating left ventricular (LV) dilatation, moderate LV hypertrophy.
Figure 2
Figure 2
Apical four chamber view demonstrating the 19×7 mm thrombus in the left ventricular apex.
Figure 3
Figure 3
Cardiac MRI demonstrates the distal inferior wall focal transmural infarction and apical thrombus.
Figure 4
Figure 4
Cardiac MRI demonstrates the right ventricular insertion site scar.
Figure 5
Figure 5
Cardiac MRI demonstrates the non-specific mid-lateral wall scar.
Figure 6
Figure 6
Parasternal long-axis view demonstrating normalisation of left ventricular (LV) size, severe LV hypertrophy.
See this image and copyright information in PMC

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