Coronary artery disease mimicking Tako-tsubo cardiomyopathy: a case report

Area of Science:

• Cardiology
• Cardiovascular Diseases
• Internal Medicine

Background:

• Tako-tsubo cardiomyopathy (TTC) typically affects post-menopausal women, presenting as myocardial infarction with ST elevation and apical ballooning on angiography.
• Coronary artery disease is usually an exclusion criterion, but co-occurrence has been reported, complicating differential diagnosis.

Observation:

• This report details a unique case of a young patient with findings atypical for classic Tako-tsubo cardiomyopathy.
• The patient presented with coexisting atherosclerotic lesions, a smaller diameter of apical systolic ballooning, and no significant increase in cardiac enzymes.

Findings:

• The case challenges the classical presentation of TTC by demonstrating its occurrence in a younger individual with concurrent coronary artery disease.
• Atypical features included the extent of apical ballooning and the absence of elevated cardiac biomarkers, necessitating a broader diagnostic consideration.

Implications:

• This case underscores the importance of considering Tako-tsubo cardiomyopathy in younger patients, even with underlying coronary artery disease.
• It suggests that diagnostic criteria for TTC may need refinement to encompass a wider spectrum of clinical presentations.
• Further research is warranted to understand the pathophysiology and management of TTC in diverse patient demographics and co-morbidities.