Recurrent takotsubo cardiomyopathy : variable pattern of ventricular involvement.

Abstract:

BACKGROUND:Takotsubo cardiomyopathy (TTC) is a transient left ventricular (LV) dysfunction that predominantly affects older women and has three main variants: apical, mid-ventricular, and basal. The recurrence rate of TTC is roughly around 11 % at 4-year follow-up. The pathogenesis of TTC is not clear and various theories have been proposed without concrete evidence. CASE SERIES:We present a case series of 3 patients with recurrent TTC involving a different region of the ventricle during recurrence. All the patients presented with acute coronary syndrome (ACS) during the initial and recurrent episode. At the initial presentation, all the patients underwent selective coronary angiography (CA), transthoracic echocardiography (TTE), and cardiac magnetic resonance imaging (CMR) evaluation. However, the recurrent episodes were diagnosed without the need of CA, except in 1 patient who presented with ST-segment elevation myocardial infarction. CONCLUSION:Recurrence of TTC is common and can be diagnosed without CA in some cases. During recurrence, the regional involvement of the left ventricle can vary in the same person. Variable regional involvement in the same patient rules out some of the proposed theories on the pathogenesis such as: beta-receptor gradient, wrap-around left anterior descending, and coronary artery spasm.

journal_name

Herz

journal_title

Herz

authors

Singh K,Parsaik A,Singh B

doi

10.1007/s00059-013-3896-x

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

963-7

issue

8

eissn

0340-9937

issn

1615-6692

journal_volume

39

pub_type

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