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Case Reports in Medicine
Volume 2013 (2013), Article ID 793193, 4 pages
http://dx.doi.org/10.1155/2013/793193
Case Report

The Ace of Spades: Reverse Takotsubo Cardiomyopathy in the Context of Angiographic Embolization of Recurrent Metastatic Serotonin-Positive Neuroendocrine Tumour of the Pancreas

1McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1
2Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1
3Department of Pathology and Molecular Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1
4Division of Cardiology, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1

Received 22 September 2012; Revised 20 December 2012; Accepted 31 December 2012

Academic Editor: Hisao Ogawa

Copyright © 2013 Ian A. Mazzetti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 62-year-old woman undergoing embolization of recurrent neuroendocrine tumor, positive for serotonin, developed chest pain and bradycardia with lateral ST-segment depression. Cardiac biomarkers were elevated, and echocardiography revealed akinesis of all basal segments with a normally contracting apex. The absence of flow-limiting coronary disease on angiography confirmed the presence of reverse Takotsubo cardiomyopathy. After optimal medical therapy for six weeks, left ventricular function returned to normal. Takotsubo cardiomyopathy has been described across a wide variety of hyperadrenergic states; the description of the reverse-type Takotsubo cardiomyopathy in the setting of embolization of recurrent neuroendocrine with serotonergic positivity tumour is novel.