Takotsubo Cardiomyopathy Masquerading as Acute Coronary Syndrome
Shankar Iyer1, Subhash Shivtarkar2, Ameya Udyavar3
1Cardiology Registrar.
Insights
Takotsubo cardiomyopathy, a rare condition, mimics acute coronary syndrome (ACS) with chest pain and ECG changes but has normal coronary arteries. This case highlights its diagnosis in a 45-year-old female presenting with dyspnea and chest pain.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Takotsubo cardiomyopathy (TTC), or transient left ventricular apical ballooning syndrome, is a rare condition.
- It can mimic acute coronary syndrome (ACS), presenting with chest pain, dyspnea, ECG changes, and elevated cardiac enzymes.
Observation:
- A 45-year-old female presented with acute dyspnea and chest pain.
- She exhibited severe ECG ischemic changes and elevated troponin levels, initially treated as ACS.
Findings:
- Coronary angiography revealed normal coronary arteries, ruling out ACS.
- Further workup confirmed the diagnosis of Takotsubo cardiomyopathy.
Implications:
- This case underscores the importance of considering TTC in patients with ACS-like symptoms and normal coronaries.
- Accurate diagnosis of Takotsubo cardiomyopathy is crucial for appropriate patient management and avoiding unnecessary interventions.
Abstract:
Takotsubo cardiomyopathy, also called transient left ventricular apical ballooning syndrome or Gebrochenes-Herz-Syndrome, is a rare entity which may masquerade as acute coronary syndrome (ACS) with sudden onset of chest pain and/or dyspnea, transient left ventricle apical akinesia, electrocardiographic changes typical of ACS and mild increase in cardiac enzymes in the background of normal coronary arteries. Here, we present a case of a 45 year old female who presented with acute onset dyspnea and chest pain with severe ischemic changes on the ECG and raised troponin levels. She was treated with a provisional diagnosis of an ACS but on further workup was found to have Takotsubo cardiomyopathy. Her presentation to the hospital along with relevant clinical findings, electrocardiographic, echocardiographic and angiographic findings are presented in the article.
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