It was reported that on an unknown date, that a 12-10mm amplatzer duct occluder was successfully implanted in a patient that was previously diagnosed with a patent ductus arteriosus defect and sustained atrial fibrillation.It was noted the following day after implant, that although the patient did not experience any chest symptoms, a "huge negative t-wave" was detected on an electrocardiogram.The patient was experiencing an arrhythmia, but there was no elevation of serum creatine kinase detected.It was noted that the patient's left ventricle apex had become ballooned and there was excessive contraction at the base of the left ventricle.The patient was diagnosed with tako-tsubo-like left ventricular dysfunction.The patient was administered an angiotensin-converting enzyme (ace) inhibitor.A week later, the left ventricle function improved and the negative t-wave detected on the electrocardiogram had normalized.Thereafter, the patient did not experience any symptoms of congestive heart failure for two years.The article concludes that after the closure of the patent ductus arteriosus, the preload of the left ventricle decreases.However in this case study the afterload of the left ventricle increased.Those hemodynamics changes may result in stress to the left ventricle and results in tako-tsubo like ventricular dysfunction.This is especially true in an older patient that has less of an ability to compensate for these hemodynamic changes.This will require more attentive monitoring of geriatric patient's.
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