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[Tako-tsubo cardiomyopathy in a patient with hypertrophic cardiomyopathy with obstruction]

Aneta I Gziut1, Elżbieta Piechocka, Tomasz Pawłowski

  • 1Klinika Kardiologii Inwazyjnej, CSK MSWiA, Warszawa. anetagziut@poczta.onet.pl

Kardiologia Polska
|March 21, 2012
PubMed

Insights

A patient experienced chest pain, initially suspected as myocardial infarction. However, diagnostic tests revealed stress-induced cardiomyopathy with left ventricle outflow obstruction, not a typical heart attack.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Medical Diagnostics

Background:

  • A 74-year-old patient presented with chest pain suggestive of Non-ST elevation myocardial infarction following significant stress.
  • Initial suspicion of acute coronary syndrome prompted admission to the Invasive Cardiology Department.

Observation:

  • Coronary angiography revealed normal coronary arteries, ruling out obstructive coronary artery disease.
  • Ventriculography demonstrated apical ballooning and near-complete occlusion of the left ventricle cavity.
  • Echocardiography indicated asymmetric hypertrophy of the heart walls and significant left ventricle outflow tract obstruction.

Findings:

  • The diagnostic workup excluded myocardial infarction and coronary artery disease.
  • Findings were consistent with stress-induced cardiomyopathy (Takotsubo cardiomyopathy) presenting atypically.
  • Cardiac magnetic resonance imaging was considered due to initial suspicion of a cardiac tumor.

Implications:

  • This case highlights the importance of considering stress-induced cardiomyopathy in patients with chest pain and normal coronaries.
  • Accurate diagnosis is crucial for appropriate management and differentiating from other cardiac emergencies.
  • Advanced imaging modalities like cardiac MRI may be necessary for comprehensive evaluation in complex cases.

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