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Takotsubo Cardiomyopathy Presenting as Wellens' Syndrome
R Scott Taylor1, Leif Skjerli2, John Ashurst1
1Duke LifePoint Conemaugh Memorial Medical Center, Department of Emergency Medicine, Johnstown, Pennsylvania.
Insights
Takotsubo cardiomyopathy can mimic Wellens' syndrome, a sign of critical coronary artery blockage. This case highlights that Takotsubo cardiomyopathy can present with Wellens' syndrome ECG findings despite normal coronary arteries.
Area of Science:
- Cardiology
- Neurology
Background:
- Takotsubo cardiomyopathy (TTC), or stress cardiomyopathy, involves transient left ventricular dysfunction.
- Wellens' syndrome on ECG suggests critical left anterior descending artery occlusion, necessitating urgent cardiac catheterization.
Observation:
- A patient presented with ECG findings characteristic of Wellens' syndrome.
- The patient experienced a seizure prior to the ECG findings.
Findings:
- Cardiac catheterization revealed angiographically normal coronary arteries.
- The patient was diagnosed with Takotsubo cardiomyopathy, not coronary artery disease.
Implications:
- This case underscores the importance of considering Takotsubo cardiomyopathy in patients presenting with Wellens' syndrome.
- ECG patterns can be misleading, and further investigation is crucial for accurate diagnosis and appropriate management of cardiac emergencies.
Abstract:
Takotsubo cardiomyopathy, also known as apical ballooning syndrome and stress cardiomyopathy, is a transient systolic and diastolic left ventricular dysfunction with a variety of cardiac wall-motion abnormalities that is increasingly being associated with significant morbidity and mortality. Wellens' syndrome is an electrocardiographic (ECG) pattern in a pain-free patient that is indicative of critical occlusion of the left anterior descending coronary artery requiring immediate cardiac catheterization. The authors report a case of a patient presenting with ECG findings consistent with Wellens' syndrome that was later found to have Takotsubo cardiomyopathy with angiographically normal coronary arteries on cardiac catheterization after a seizure.