IMR Press / RCM / Volume 13 / Issue 4 / DOI: 10.3909/ricm0647

Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with MedReviews, LLC.

Open Access Case Review
Apical Ballooning Syndrome Associated With Isolated Severe Hyponatremia: Case Report and Suggested Pathophysiology
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1 Pat and Jim Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, CT
2 Department of Cardiovascular Medicine, Lenox Hill Hospital, New York, NY
Rev. Cardiovasc. Med. 2012, 13(4), 198–202; https://doi.org/10.3909/ricm0647
Published: 30 December 2012
Abstract
An 82-year-old woman who presented to her primary care physician for preoperative evaluation was incidentally found to have severe hyponatremia (sodium =118 mmol/L). The patient was then admitted for workup and treatment of hyponatremia. On day 2 of the admission, the patient was found to have new T-wave inversions on a telemetry monitor. Further workup, including an electrocardiogram, cardiac markers, echocardiogram, and a cardiac catheterization were consistent with the diagnosis of apical ballooning syndrome (ABS). Mechanisms of how severe hyponatremia may lead to ABS are discussed as well as a possible approach to the management of severe hyponatremia in postmenopausal women.
Keywords
Takotsubo cardiomyopathy
Apical ballooning syndrome
Broken heart syndrome
Hyponatremia
Mechanism
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