南予医誌 Vol.14 No. １ 2013－62－受稿日 平成25年４月２日受理日 平成25年７月１日連絡先 〒798-8510 愛媛県宇和島市御殿町1-1 市立宇和島病院 内科 池田 俊太郎IntroductionAmpulla cardiomyopathy (so-called “Ta-kotsubo cardiomyopathy”), a novel cardiac syndrome with acute onset, reversible left ventricular apical wall motion abnormalities Abstract An 82-year-old female patient presented herself to our emergency department because of severe chest pain. Emergency coronary angiography revealed no significant epicar-dial coronary stenosis, while left ventriculography showed asynergistic apical ballooning with basal hyperkinesis, the so-called “Takotsubo pattern”. Doppler echocardiography indicated the presence of a left ventricular pressure gradient simulating hypertrophic ob-structive cardiomyopathy. After propranolol injection, the left ventricular pressure gradient decreased. Left ventriculography performed 20 days after admission demonstrated normal wall motion. I-123-β-metyl-iodobenzyl-guanidine (MIBG) myocardial scintigraphy demon-strated an increased heart–mediastinal ratio. These results may indicate that myocardial hypersensitivity to adrenergic stimulation and intrinsic impairment of the microcirculation contribute to the pathogenesis of this syndrome. （Nan-yo Med J 2013；14：62-70.）Key Words：ampulla cardiomyopathy, left ventricular obstruction, β-blocker“Ampulla cardiomyopathy” with transient left ventricular obstruction successfully treated with a β-blocker: a case reportShuntaro IKEDA, Sayuri UGA, Chika MURAKAMI, Masayuki NAKAMURA, Hisaki KADOTA, Hideaki SHIMIZU,Kiyotaka OHSHIMA, Mareomi HAMADADepartment of CardiologyUwajima City Hospital1-1, Goten-machi, Uwajima, Ehime 798-8510, JAPAN
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