Takotsubo cardiomyopathy in a Caucasian Italian woman: case report

• Published in: Cardiovascular ultrasound 2007-04, Vol.5 (1), p.18-18, Article 18
• Main Authors: Lisi, Matteo, Zacà, Valerio, Maffei, Silvia, Casucci, Francesca, Maggi, Marianna, Lunghetti, Stefano, Aitiani, Paolo, Carrera, Arcangelo, Castellani, Debora, Favilli, Roberto, Pierli, Carlo, Mondillo, Sergio
• Format: Article
• Language: English
• Subjects: Aged; Cardiomyopathies - complications; Cardiomyopathies - diagnosis; Cardiomyopathies - drug therapy; Cardiovascular Agents - therapeutic use; Case Report; Coronary Angiography; Echocardiography; Electrocardiography; Female; Humans; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - etiology
• ISSN: 1476-7120; 1476-7120
• DOI: 10.1186/1476-7120-5-18

Takotsubo cardiomyopathy is an acute cardiac syndrome characterized by transient LV regional wall motion abnormalities (with peculiar apical ballooning appearance), chest pain or dyspnea, ST-segment elevation and minor elevations of cardiac enzyme levels A 68-year-old woman was admitted to the Emergency Department because of sudden onset chest pain occurred while transferring her daughter, who had earlier suffered a major seizure, to the hospital. The EKG showed sinus tachycardia with ST-segment elevation in leads V2-V3 and ST-segment depression in leads V5-V6, she was, thus, referred for emergency coronary angiography. A pre-procedural transthoracic echocardiogram revealed regional systolic dysfunction of the LV walls with hypokinesis of the mid-apical segments and hyperkinesis of the basal segments. Coronary angiography showed patent epicardial coronary arteries; LV angiography demonstrated the characteristic morphology of apical ballooning with hyperkinesis of the basal segments and hypokinesis of the mid-apical segments. The post-procedural course was uneventful; on day 5 after admission the echocardiogram revealed full recovery of apical and mid-ventricular regional wall-motion abnormalities. Takotsubo cardiomyopathy is a relatively rare, unique entity that has only recently been widely appreciated. Acute stress has been indicated as a common trigger for the transient LV apical ballooning syndrome, especially in postmenopausal women. The present report is a typical example of stress-induced takotsubo cardiomyopathy in a Caucasian Italian postmenopausal woman.