• Pediatr Crit Care Me · Nov 2011

    Case Reports

    Neurogenic stunned myocardium presenting as left ventricular hypertrabeculation in childhood: a variant of Takotsubo cardiomyopathy?

    • Gabriella De Rosa, Manuela Pardeo, Concezio Di Rocco, Domenico Pietrini, Sonia Mensi, Eleonora Stival, Alessia De Nisco, Laura Marzano, Daniele De Luca, and Marco Piastra.
    • Department of Pediatrics, Catholic University Medical School, A.Gemelli Hospital, Rome, Italy.
    • Pediatr Crit Care Me. 2011 Nov 1;12(6):e420-3.

    ObjectiveTo report the first case of neurogenic stunned myocardium presenting with heart left ventricle noncompaction requiring intensive care in the perioperative period of tension tumor-induced hydrocephalus.Methods And DesignCase report and literature review. Our Institutional Review Board waived the need for consent.PatientA 12-yr-old female with intracranial astrocytoma and hypertensive hydrocephalus presented with severe heart dysfunction and life-threatening ventricular ectopies intraoperatively. A severe heart failure developed requiring hemodynamic and ventilatory support for 10 days. Echocardiography showed a transient noncompaction aspect of the left ventricular wall, further confirmed by a cardiac magnetic resonance image. The noncompaction aspect lasted until 15 days postadmission, as was the case for the QT interval prolongation; no life-threatening ectopies were demonstrated on the subsequent Holter electrocardiogram monitoring.ConclusionsThis report describes a unique presentation of myocardial stunning in association with an intracranial illness, namely, a hypertensive hydrocephalus complicating an intracranial neoplasm.

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