Inverted takotsubo cardiomyopathy

Area of Science:

• Cardiology
• Cardiovascular Medicine
• Clinical Case Reports

Background:

• Takotsubo cardiomyopathy (TTC) typically presents as apical ballooning in post-menopausal women.
• Inverted takotsubo cardiomyopathy (iTTC) is a variant with basal akinesis, often linked to neurologic disorders or pheochromocytoma, predominantly in females.
• The pathophysiology of TTC and its variants remains under investigation.

Observation:

• A rare case of iTTC is presented in a 78-year-old male.
• The patient experienced iTTC following acute abdominal pain attributed to biliary colic.
• This presentation occurred in the absence of acute neurologic disorders or pheochromocytoma.

Findings:

• This case represents an extremely rare instance of iTTC precipitated by acute physical stress in a male patient.
• Literature review indicates a significant underrepresentation of iTTC in males, particularly when triggered by non-neurologic, non-endocrine stressors.
• The study discusses the incidence and gender distribution of iTTC.

Implications:

• This case expands the known clinical spectrum of iTTC triggers.
• It underscores the importance of considering iTTC in male patients presenting with acute stress, even with atypical symptoms.
• Further research is needed to elucidate the specific mechanisms and prevalence of iTTC across different demographics and stressor types.