A Mid-Ventricular Variant of Takotsubo Cardiomyopathy: A Case Study and Review of Literature

Abstract

Different variants of Takotsubo cardiomyopathy (TC) have been described recently. In the present case, we report a post-menopausal woman who had been experiencing significant emotional distress, admitted with typical chest pain, electrocardiographic changes, and elevated troponin levels. She underwent left heart catheterization that demonstrated mild nonobstructive coronary disease and mid-ventricular focal wall motion abnormality, consistent with the mid-ventricular variant of TC. One month after her discharge, a repeated echocardiogram showed preserved ejection fraction and no wall motion abnormalities. In the mid-ventricular variant, we usually observe a unique end-systolic appearance that resembles a Greek vase. It is possible that atypical patterns of left ventricle (LV) dysfunction related to TC are being underrecognized. Therefore, this case study highlights the importance of recognizing less frequent variants of TC.

Triangular ECG Pattern in a Young Female with COVID-19

“…Although the pathophysiology of Takotsubo cardiomyopathy is not yet fully understood, it is believed to be related to a stress-induced catecholamine surge several times higher than those in patients with STsegment elevation acute coronary syndrome. 4 The most common presentation is that of apical ballooning of the left ventricle during systole; however, there are additional morphological variants including the basal, focal, mid-ventricular, biventricular (apical and right ventricle), and isolated right ventricular focal wall motion abnormalities. 5 Although there are reports of confirmed Takotsubo cardiomyopathy in patients with COVID-19, 6 The American Journal of Medicine, Vol 000, No 000, && 2020 coronary angiography makes definitive diagnosis challenging.…”