Takotsubo Cardiomyopathy: A Recognizable Phenotype: Mid-Cavity Variant

Abstract

Takotsubo cardiomyopathy is an important differential consideration when a patient presents with an acute coronary syndrome. Patients typically present with chest pain/pressure, shortness of breath, electrocardiographic changes, elevated biomarkers, normal or near normal coronary arteries, and wall motion abnormalities that are not consistent with a single coronary vascular bed. This constellation of findings is often associated with a precipitating emotional or physical stressor. Variants of the classic left ventricular apical ballooning syndrome, including midand basal left ventricular wall motion abnormalities, are being more frequently recognized. The recognition and diagnosis of takotsubo cardiomyopathy has important implications for clinical management initially and in follow up. A small subset of patients may experience life-threatening complication during initial presentation, however, most patient recover and have a favorable longterm prognosis. The pathophysiology of takotsubo cardiomyopathy remains an enigma, but a surfeit of catecholamines seems pertinent to the underlying pathophysiology.