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Multivessel Coronary Artery Vasospasm-Induced Takotsubo Cardiomyopathy

Vishal I Patel1,2, Serap Sobnosky1,2,3

  • 1St. Mary Medical Center, Department of Internal Medicine, USA.

Case Reports in Cardiology
|January 27, 2022
PubMed

Insights

Takotsubo cardiomyopathy can be caused by diffuse coronary artery vasospasm. This case report details the first angiographically confirmed instance of this rare Takotsubo cardiomyopathy trigger.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine

Background:

  • Takotsubo cardiomyopathy (TTC) is characterized by reversible left ventricular dysfunction and an acute stressor.
  • Epicardial coronary vasospasm is an infrequently documented cause of TTC, with poorly understood mechanisms.

Observation:

  • A 54-year-old female presented with chest pain and ST-elevation myocardial infarction.
  • Coronary angiography revealed diffuse multivessel coronary artery vasospasm without obstructive coronary artery disease.

Findings:

  • The patient was diagnosed with Takotsubo cardiomyopathy attributed to diffuse multivessel coronary artery vasospasm.
  • This represents the first angiographically confirmed case of TTC caused by diffuse multivessel vasospasm, expanding on existing literature typically involving focal or single-vessel vasospasm.

Implications:

  • This case highlights diffuse multivessel coronary artery vasospasm as a significant, albeit rare, etiology for Takotsubo cardiomyopathy.
  • Management strategies may benefit from a multimodal approach targeting vasospastic disease in TTC patients.

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