Electrocardiogram attenuation of QRS complexes in association with Takotsubo syndrome

摘要

To the Editor: The interesting case report by Rojas-Marte et al. [1 ], published ahead of print in the Journal on July 31,2014, about a 31 year-old woman who suffered Takotsubo syndrome (TTS), complicated by cardiac arrest and cardiogenic shock, following an overdose of ibuprofen and diphenhy-dramine, and was treated successfully with extracorporeal membrane oxygenation, provides me with the opportunity to bring to the attention of the authors a newly described association of TTS with early transient electrocardiogram (ECG) attenuation of the QRS complexes (ATTQRS) [2,3]. Perusal of the 3 ECGs recorded upon admission, at ~1 hour, and at 36 hours later, reveals ATTQRS in the limb leads which are evident by comparison between the ECG #3 and ECGs, #1 and #2. Also transient ATTQRS with subsequent restoration of the amplitude of the QRS complexes was shown in the precordial leads (particularly V3 - V5), evident by comparisons of the 3 ECGs [1]. These ATTQRS, which may have a role in the diagnosis of TTS, have been attributed to the ensuing myocardial edema, as detected by cardiac magnetic resonance imaging [2,3]. I would be grateful to the authors if they could provide a comparison of the 3 ECGs, with a possibly available ECG prior to the inception of TTS, or subsequent ECGs recorded during hospitalization or at follow-up.