Isolated right ventricular takotsubo cardiomyopathy: a case report and literature review

In about one quarter of patients with stress-induced takotsubo cardiomyopathy (TC) concomitant involvement of right ventricle (RV) can be observed. Opposite to this biventricular form of TC, isolated right ventricular takotsubo cardiomyopathy (RVTC) was described only in a few cases and so far has not been listed as a specific type of TC. The authors present a case of a 87-year-old demented female admitted with pneumonia in whom echocardiography revealed RV apical ballooning while the left ventricle function was quite normal. RV apical thrombus was also found. Initial ECG showed QR in V1, discrete ST elevation in V1-2 leads and low voltage of QRS complex in limb leads. There was only a slight increase in troponin I level but a marked BNP elevation. Despite treatment, the course of the disease ended in a fiasco. The authors compare the clinical picture of the patient presented with the data of the 6 remaining cases of isolated RVTC found in the literature. Routine echocardiographic evaluation of RV in different clinical situations which may trigger TC should show actual occurrence of isolated RVTC.