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Photon-counting CT of midventricular takotsubo cardiomyopathy
Ismaiel Chikh Bakri1, André Euler1
1Department of Radiology, Kantonsspital Baden, affiliated Hospital for Research and Teaching of the Faculty of Medicine of the University of Zurich, Im Ergel 1, 5404 Baden, Switzerland.
Abstract:
Midventricular Takotsubo cardiomyopathy is an atypical variant of stress-induced cardiomyopathy characterized by circumferential midventricular hypokinesia with basal and apical sparing. We present the case of a 63-year-old woman presenting with acute chest pain and elevated cardiac troponin I following emotional stress. While echocardiography initially suggested apical involvement, Photon-Counting Detector Coronary CT Angiography (PCD-CCTA) provided a comprehensive "1-stop-shop'' assessment. The high-resolution photon-counting acquisition excluded obstructive coronary artery disease, while multiphase cine reconstructions definitively characterized the midventricular wall-motion abnormalities. Diagnosis was confirmed by the complete resolution of wall-motion abnormalities on follow-up cardiac MRI. This case highlights the capability of emerging photon-counting CT technology to simultaneously assess coronary anatomy and ventricular function, facilitating the rapid diagnosis of atypical cardiomyopathy variants.
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