Cor Vasa 2014, 56(5):e403-e410 | DOI: 10.1016/j.crvasa.2013.09.004

Uncommon type of tako-tsubo cardiomyopathy - Case report and current view

A. Qadeer Negahban^a,*, Jan Máchal^b, Roman Panovský^a, Věra Feitová^c

^a Mezinárodní centrum klinického výzkumu - I. interní kardioangiologická klinika, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice u sv. Anny v Brně, Brno, Česká republika

^b Ústav patologické fyziologie, Lékařská fakulta Masarykovy univerzity, Brno, Česká republika

^c Mezinárodní centrum klinického výzkumu - Klinika zobrazovacích metod, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice u sv. Anny v Brně, Brno, Česká republika

Tako-tsubo cardiomyopathy is a heart disease that imitates acute myocardial infarction. Classical findings include apical and mid segment hypokinesia. However, it may have different appearance than was originally described.
In our case report we describe a case of a woman with tako-tsubo cardiomyopathy (TTC), who was admitted to hospital after a stressful event because of chest pain, with normal coronary angiogram and mild elevation of Troponin-I level.
Electrocardiogram corresponded with non-Q myocardial infarction of inferior wall.
Following left ventriculography, echocardiography and magnetic resonance, impaired contractility of the basal part of inferior wall was noticed, together with good overall ejection fraction. Full recovery was attained in five weeks after the onset.
This impairment of left ventricle is not typical for TTC. In our patient, the basal part of left ventricle was affected, and not the apex as it is usually seen in TTC. This finding corresponds to rare "inverted" form of TTC. Another atypical feature is segmental involvement that, moreover, covered the inferior wall. This morphological pattern, according to our best knowledge, has not yet been described in literature.
Pathophysiology, epidemiology and clinical significance are shortly reviewed in the paper.

Keywords: Coronary angiography; Late gadolinium enhancement; Myocardial stunning; Tako-tsubo cardiomyopathy

Received: April 27, 2013; Revised: September 17, 2013; Accepted: September 20, 2013; Published: October 1, 2014  Show citation