‘Broken Heart’ syndrome in Scotland: a case of Takotsubo cardiomyopathy in a recently widowed lady

• Published in: Scottish medical journal 2013-02, Vol.58 (1), p.e15-e19
• Main Authors: Mukherjee, A, Sünkel-Laing, B, Dewhurst, N
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - diagnosis; Aged; Diagnosis, Differential; Female; Grief; Humans; Myocardial Infarction - diagnosis; Takotsubo Cardiomyopathy - diagnosis; Widowhood
• ISSN: 0036-9330; 2045-6441
• DOI: 10.1177/0036933012474605

Takotsubo cardiomyopathy (TCM), first described in Japan in the early 1990s, is a reversible non-ischaemic cardiomyopathy of unclear aetiology characterised by transient left ventricular dysfunction. It mimics acute myocardial infarction with ST segment changes (STEMI), although evidence of occlusive coronary artery disease is absent. TCM is typically triggered by an intense physical or emotional stress event. We report a case of TCM diagnosed in a recently widowed lady in whom a myocardial infarction was initially suspected. This case illustrates the importance of an awareness of this unique clinical entity. Without appreciation of differentiating features, TCM can easily be misdiagnosed as an acute coronary syndrome. Misdiagnosis and the subsequent inappropriate and potentially harmful use of fibrinolytic therapy can be avoided through careful history-taking, clinical examination and appropriate investigations. Although well reported in the medical literature, this case of TCM provides the basis of a timely summary and update on current understanding of this perplexing condition.