Apical Takotsubo Syndrome After Elective Stenting of the Left Anterior Descending Artery

Takotsubo syndrome (TS) is a transient stress-induced left ventricular dysfunction that may clinically mimic acute myocardial infarction (MI). Its occurrence after percutaneous coronary intervention is rare, and it may be misinterpreted as a procedural complication, including type 4a MI.

We describe a 77-year-old woman with stable coronary artery disease who developed apical TS shortly after elective stenting of the left anterior descending artery. Postprocedural chest pain and electrocardiographic changes raised suspicion of acute MI. However, coronary angiography demonstrated patent stent implantation without evidence of acute thrombosis. Cardiac magnetic resonance imaging confirmed apical ballooning with myocardial edema in the absence of necrosis, consistent with TS.

TS after percutaneous coronary intervention is an uncommon but important diagnostic consideration. Differentiation from periprocedural MI requires integration of clinical findings, coronary imaging, and cardiac magnetic resonance imaging. Recognition of this condition is essential to avoid unnecessary escalation of antithrombotic therapy and to guide appropriate management.