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Published 15 September 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.12.2008.1366]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Reminder of important clinical lesson

Political riots in Pakistan and stress-induced cardiomyopathy: a case report

Sadia Arshad, Sajid Hameed Dhakam

Aga Khan University Hospital, Medicine, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan

Correspondence to:
Sadia Arshad, sadiaarshad99{at}gmail.com

SUMMARY

A previously healthy middle-aged lady with no prior risk factors for coronary artery disease presented with chest discomfort and ECG changes suggestive of anterolateral ST elevation myocardial infarction. She had had a stressful event prior to the onset of symptoms in that she had been caught up in a riot and had been exposed to intense mental and physical stress. She was found to have severe global left ventricular dysfunction but coronary artery disease was not discovered on coronary angiography. She was treated with antiplatelets, statins, diuretics and aldosterone antagonists. Her left ventricular function was revealed to have improved to normal as shown on echocardiography done on her follow-up 2 months after initial presentation.


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