4 × 5.2 cm in only 8 days, and although its size was big enough to obstruct the left ventricular inflow, they reported there was no significant obstruction to the left pulmonary venous return. The hematoma in that report was much bigger than in our case so we do not suggest preserved venous return as the only decision-making parameter for conservative treatment.

In conclusion, LA dissection does occur, though rarely, after mitral valve Inhibitors,research,lifescience,medical surgery. Careful TEE examination during operation is essential to avoid detrimental results. A certain form of LA dissection can be managed conservatively according to its location, size and entity.
Takotsubo cardiomyopathy has clinical features that resemble an acute coronary syndrome, Inhibitors,research,lifescience,medical such as chest pain, ST-segment changes in the anterior precordial leads on electrocardiogram, mild elevation of serum cardiac enzymes, and transient left ventricular dysfunction with marked PI3K inhibitor review apical ballooning. The general prognosis is considered to be favorable, although some investigators have reported cases with various complications.1) This is a case of a 63-year-old woman with systemic lupus erythematosus (SLE) who suffered from Inhibitors,research,lifescience,medical persistent apical ballooning complicated by an apical thrombus in a suspected takotsubo cardiomyopathy.

This case may be important because left ventricular thrombus may occur occasionally and not all takotsubo cardiomyopathy may recover completely. CASE A 63-year-old Korean woman with a past medical history of hypertension and a 25-year history of SLE presented with a 3-week history of shortness of breath. She had been treated with hydroxychloroquine 400 mg/day and varying doses of prednisone between 5 and 15 mg/day for the SLE. Additionally, Inhibitors,research,lifescience,medical the hypertension was under control with carvedilol 25 mg/day. On examination, her blood pressure was 110/70 mmHg,

pulse rate was 112 beats/min, respiratory rate was 24 breaths/min, and body temperature was 36.5℃. Jugular venous distention was noted on inspection. On cardiac auscultation, her rhythm was noted to be tachycardic but regular, weak summation gallops were heard Inhibitors,research,lifescience,medical at the cardiac apex, and no pericardial friction rubs were appreciated. Blood tests showed a white blood cell count of 4000/mm3 (normal, 4300-9400/mm3), hemoglobin of 11.5 g/dL (normal, 12-14.3 g/dL) and platelet Cell press count of 67000/mm3 (normal, 169-365/mm3). The C-reactive protein level was found to be 0.29 mg/L (normal, 0-0.75 mg/L). A blood chemistry panel revealed a blood urea nitrogen level of 25.0 mg/dL (normal, 7-20 mg/dL), creatinine of 1.3 mg/dL (normal, 0.5-1.5 mg/dL), total protein of 6.7 g/dL (normal, 6.0-8.3 gm/dL), and albumin of 3.2 g/dL (normal, 3.5-4.5 mg/dL). Analysis of the urinary sediment revealed 1-4 white blood cells/high power field (hpf), many red blood cells/hpf, and trace levels of proteinuria. Cardiac enzymelabs were drawn and found to be elevated: CK-MB of 8.7 U/L (normal, 0.6-6.3 U/L), troponin-I of 0.35 ng/mL (normal, 0.0-0.