P436 ASSOCIATION BETWEEN REVERSE–TAKO–TSUBO E NEUROLOGICAL DISORDER

Abstract Reverse–Tako–tsubo (r–TTC) is a rare variant of Tako–tsubo syndrome (TTC). TTC characterized by transient and reversible left ventricular systolic dysfunction, for which an emotional or physical stressful trigger can usually be identified. Clinically, it mimics acute myocardial infarction, with elevation cytonecrosis enzymes no obstractive coronary artery stenosis. On imaging, r–TTC hypokinesia the mid–basal regions associated hyperkinesia apical region that resolves spontaneously. Case report: 78–year–old female affected cerebral atrophy, leukoencephalopathy, cognitive impairment, behavior disorders. Reported episode loss consciousness lasting several minutes, spontaneously resolving tremors hemisome hyposthenia. When she arrived in emergency room, haematological tests found high troponin values. CT brain without contrast, evidence alterations encephalic tissues referable to lesions, but showed diffuse supratentorial leukoaraiosis widening cerebrospinal fluid spaces on atrophic basis. The neurological evaluation excludes presence seizure. electrocardiogram negative T waves QTc 636 ms. angiography didn’t show significant arteries stenosis ventriculography normal dimensions total akinesia mid segments normokinesia ejection fraction 50%. With these findings diagnosis was made. Transthoracic color Doppler echocardiography confirmed kinetics observed ventriculography. Conclusions compared CTT, lower decline global function and, as reported literature, there greater connection insults triggering factors, such episodes aneurysmal subarachnoid hemorrhage, surgery, ischemic stroke seizures traumatic injury. underlying mechanisms are still unknown, crucial role catecholamine–induced cardiotoxicity, microvascular dysfunction vasospasm and/or estrogen deficiency hypothesized.