E.A. Vertinsky, L.Yu. Ushakova, M.V. Novikova
Stress cardiomyopathy, also called Takotsubo syndrome (TTS), broken heart syndrome and stress-induced cardiomyopathy, is characterized by transient regional systolic dysfunction of the left ventricle (LV) in the absence of angiographic evidence of obstructive coronary artery disease or acute plaque rupture as well as by regional wall motion abnormalities that extend beyond a single coronary vascular bed. TTS accounted for 1,7% to 2,2% of cases presenting with suspected acute coronary syndrome (ACS) or ST-elevation infarction in a systematic review. According to the International Takotsubo Registry, of 1750 patients with TTS, 89.8% were women (mean age 66,8 years). Complete recovery of LV systolic function is necessary to confirm the diagnosis of Takotsubo cardiomyopathy and can happen over a period of days to weeks. The typical and most common description of TTS is the apical type (81,7%), evident in the characteristic abnormality of a ballooned left ventricular apex with basal segmental hyperkinesis. However, atypical variants of this syndrome with mid-ventricular (14,6%), basal (2,2%) and focal (1,5%) wall motion patterns are increasingly diagnosed. We present a patient who developed a mid-ventricular dyskinetic TTS pattern.
keywords: stress-induced cardiomyopathy, Takotsubo cardiomyopathy, Takotsubo syndrome, аcute coronary syndrome, emotional or physical stress, echocardiography, coronary arteries
for references: E.A. Vertinsky, L.Yu. Ushakova, M.V. Novikova. A rare case of focal mid-ventricular form of Takotsubo syndrome. Neotlozhnaya kardiologiya i kardioovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2019, vol. 3, no. 2, pp. 743–746
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