Takotsubo cardiomyopathy or “broken heart syndrome” – A case report

Abstract

Abstract Introduction Takotsubo cardiomyopathy (TTC) is an interesting syndrome and one of the essential elements of differential diagnosis of acute coronary syndromes. This disease entity is very rare and was first described in 1991. Aim The aim of this study is to present the disease entity of TCC, its diagnostic criteria and necessity for including it in the differential diagnosis of acute coronary syndromes. Material and methods Case report and analysis of a case of a 74-year-old patient with TTC. Case study Female patient, 74 years of age, was admitted to Cardiovascular Intensive Care Unit of Provincial Specialist Hospital in Olsztyn due to severe, acute chest pain that occurred after the death of her husband. Results and discussion TTC currently accounts for approximately 2% of initially diagnosed acute coronary syndromes. The etiology of TTC is not fully understood. Main clinical symptoms include severe, acute chest pain of sudden onset. Typically it occurs most frequently after a stressful situation, such as e.g. death of a loved one, serious surgical procedure or traffic accident. Characteristics also include changes in cardiac imaging studies (echocardiography) in the form of apical akinesis or hypokinesis, electrocardiographic abnormalities (ECG) presenting with ST-segment elevation in the anterior, lateral and inferior leads, as well as non-specific elevation of serum cardiac markers suggestive of myocardial injury. Coronary angiography does not reveal any coronary blockages. The proposed Mayo Clinic diagnostic criteria are useful for the diagnosis of the disease. Conclusions Similar clinical presentation and ECG changes indicate that this syndrome should be differentiated from ACS, particularly in atypical cases.