Dynamic Study of Myocardial Contrast-enhancement in Takotsubo-cardiomyopathy: Reversible Myocardial Injury Detected by Early Gadolinium Enhancement

Aikawa, Yukio; Noguchi, Teruo; Morita, Yoshiaki; Yamada, Naoaki; Kusano, Kengo; Anzai, Toshihisa; Goto, Yoichi; Ishihara, Masaharu; Ogawa, Hisao; Yasuda, Satoshi

doi:10.1016/j.cardfail.2014.07.253

Cited by 1 publication

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“… 4 In a study of 53 patients with TTS, 92% had early EGE. 6 Early gadolinium enhancement–positive TTS patients had delayed recovery of regional wall motion abnormalities compared to EGE-negative TTS patients. 6 Early gadolinium enhancement in TTS is likely due to hyperaemia and capillary leakage, 7 or oedema.…”

Section: Discussionmentioning

confidence: 91%

Parametric cardiovascular magnetic resonance imaging in takotsubo syndrome: a case report

Sunnasy,

Mohiaddin

2023

European Heart Journal - Case Reports

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Background Takotsubo syndrome (TTS) causes angina with ventricular dysfunction that can mimic acute coronary syndrome (ACS). Normal coronary angiography leads to cardiovascular magnetic resonance imaging (CMR) in the diagnostic pathway. Historically, TTS was thought to be associated with the absence of late gadolinium enhancement on CMR. This case report highlights the presence of late gadolinium enhancement in a case of TTS while demonstrating the other characteristic findings, including quantitative parametric T1/T2 mapping. Case Summary A 69-year-old lady was admitted with chest pain and shortness of breath. She was found to have classical TTS with the characteristic wall motion abnormalities on echocardiogram, left ventricular angiogram and CMR. Her CMR also demonstrated strongly positive myocardial T1/T2 mapping that matched the wall motion abnormalities, and the less frequently described positive early and late gadolinium enhancement. Discussion This case highlights the diagnostic pathway in TTS and the ability of CMR to make a diagnosis in myocardial infarction with non-obstructed coronary arteries (MINOCA). We describe the characteristic cardiac imaging features of TTS while discussing the positive late gadolinium enhancement patterns that may help confirm the diagnosis.

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