Presentation
Severe anterior chest pain. Ambulance crew diagnosed ST elevation inferolateral myocardial infarction. She was transferred for coronary angiography as per protocol. On arrival her chest pain settled and ECG changes resolved.
Patient Data
Interestingly the coronary angiography demonstrated that her coronary arteries were free of significant obstructive disease, with normal distal flow. The left ventriculogram demonstrated mild left ventricular end diastolic pressure elevation at 15 mmHg with mild to moderate apical ballooning, suggesting probable Takotsubo cardiomyopathy.
Case Discussion
Takotsubo cardiomyopathy, sometimes called "broken heart syndrome," is a condition that may mimic the symptoms of a STsegment elevation myocardial infarction (STEMI) but often occurs in the absence of significant coronary artery blockages. This phenomenon is worth considering when patients present with acute chest pain and other STEMI-like symptoms, but the coronary angiogram reveals normal or non-obstructive coronary arteries.
Takotsubo cardiomyopathy is characterized by a transient weakening of the heart's left ventricle and ballooning/dilatation of the left ventricular apex. This is classically triggered by emotional or physical stress. The condition can lead to severe left ventricular dysfunction and should be recognized to prevent misdiagnosis and provide appropriate management for affected individuals.
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