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The fifth takotsubo variant
Paul G Bridgman1, Christina W Chan1
1Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand.
Echocardiography (Mount Kisco, N.Y.)
|November 3, 2016
Summary
This study describes a new pattern of takotsubo cardiomyopathy, the reverse mid-ventricular type, affecting heart muscle movement. This condition, characterized by specific cardiac dysfunction, resolved within weeks.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Medical Case Reports
Background:
- Takotsubo cardiomyopathy (TTC), also known as stress-induced cardiomyopathy, is a transient left ventricular dysfunction.
- Typical TTC patterns involve apical ballooning, but atypical variants are increasingly recognized.
Observation:
- A case report details a 79-year-old woman presenting with chest pain, elevated troponin I, and EKG changes.
- Initial coronary angiography revealed minimal coronary artery disease.
- The patient exhibited a unique pattern of left ventricular (LV) dysfunction: hyperdynamic mid-LV with apical and basal akinesis/hypokinesis.
Findings:
- This pattern represents the fifth described variant of takotsubo cardiomyopathy, termed reverse mid-ventricular TTC.
- Cardiac biomarkers and EKG abnormalities normalized over time.
- Follow-up echocardiography demonstrated complete recovery of left ventricular function within six weeks.
Implications:
- Recognition of this fifth TTC pattern is crucial for accurate diagnosis and management.
- Understanding atypical TTC variants expands the spectrum of cardiac dysfunction related to stress.
- This case highlights the potential for reversible myocardial dysfunction in stress-induced conditions.
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