Suicidal left ventricle: a case report

Abstract

: We report a case of “Takotsubo cardiomyopathy” following attempted suicidal partial hanging. Takotsubo cardiomyopathy is a syndrome characterized by transient regional systolic dysfunction of the left ventricle (LV). Takotsubo cardiomyopathy was first described in 1990 in Japan. From a registry of 3,265 patients with troponin-positive ACS a prevalence of 1.2 present was reported. Takotsubo cardiomyopathy is frequently in women and mainly in older adults. The patient presented with chest pain after the suicidal attempt, electrocardiography (ECG) showed ischemic changes in the anterior leads. Echocardiography performed, which revealed that the LV showed ballooning and hypokinesia of the apical segments, and the Troponin test was positive. Coronary angiogram considering the possibility of the acute coronary syndrome was done, which showed only minimal plaguing in the left anterior descending artery. However, the LV angiogram revealed the classical features of Takotsubo cardiomyopathy. Cardiac magnetic resonance imaging (MRI) was also performed, which also confirmed the diagnosis. After three days of hospitalization, the patient was discharged with proper Psychiatric Counseling, and during the follow-up, the LV contractility had completely recovered. Takotsubo cardiomyopathy should always be considered in patients presenting with abnormal ECG during various scenarios of physical and emotional stress.