“Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy

Kan Liu; Zhongxia Sun; Tiemin Wei

doi:10.4137/CMC.S18756

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“Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy

Journal article

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Peer reviewed

“Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy

Kan Liu, Zhongxia Sun and Tiemin Wei

Clinical Medicine Insights. Cardiology, Vol.9(Suppl 1), pp.33-40

03/23/2015

DOI: 10.4137/CMC.S18756

PMCID: PMC4373721

PMID: 25861229

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Abstract

Although most patients with Takotsubo cardiomyopathy (TTC) have benign clinical course and prognosis, TTC can induce acute heart failure and hemodynamic instability. TTC mimics the clinical features of acute anterior wall myocardial infarction (AMI). Bedside clinicians often have a diagnostic dilemma when cardiac catheterization and angiography are either contraindicated or can cause potential adverse consequences. Misdiagnosing TTC as AMI will lead to initiation of harmful pharmacological or device-based treatment, which worsens hemodynamic compromise. Therefore, understanding and interpreting the unique pathophysiological and hemodynamic features of TTC in a better manner becomes crucial to guide effective clinical management of acute heart failure/cardiogenic shock during TTC. We review recent advances in echocardiographic diagnosis of TTC and its role in guiding bedside management of acute heart failure and cardiogenic shock, with specific focus on the interpretation of discrepant, but reciprocally dependent, left and right ventricular hemodynamics during acute stages of TTC.

acute heart failure

cardiogenic shock

interventricular dependency

reverse McConnell’s sign

Review

Takotsubo cardiomyopathy

Details

Title: Subtitle: “Reverse McConnell’s Sign”: Interpreting Interventricular Hemodynamic Dependency and Guiding the Management of Acute Heart Failure during Takotsubo Cardiomyopathy
Creators: Kan Liu - SUNY Upstate Medical University
Zhongxia Sun - Department of Cardiology, Lishui Central Hospital, Zhejiang University, Zhejiang, People's Republic of China.
Tiemin Wei - Department of Cardiology, Lishui Central Hospital, Zhejiang University, Zhejiang, People's Republic of China.
Resource Type: Journal article
Publication Details: Clinical Medicine Insights. Cardiology, Vol.9(Suppl 1), pp.33-40
DOI: 10.4137/CMC.S18756
PMID: 25861229
PMCID: PMC4373721
NLM abbreviation: Clin Med Insights Cardiol
ISSN: 1179-5468
eISSN: 1179-5468
Publisher: Libertas Academica
Language: English
Date published: 03/23/2015
Academic Unit: Radiology; Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984318713102771

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