Takotsubo Cardiomyopathy Mimicking Obstructive Hypertrophic Cardiomyopathy.

Abstract

Takotsubo cardiomyopathy (TCM) is characterized by transient left ventricular dysfunction, diagnosed via echocardiography or left ventriculography. In most cases, TCM involves an emotional, physical, or combined trigger. Acute coronary syndrome is one of the most frequent misdiagnoses in TCM patients due to electrocardiogram (ECG) abnormalities and elevated cardiac biomarkers. Typically, coronary angiography reveals no stenosis or occlusion of the coronary arteries. Hypertrophic cardiomyopathy (HCM) is a distinct pathology characterized by a hypertrophied left ventricle with various phenotypes. However, some reports have described TCM cases mimicking obstructive-type HCM in some patients. We present a case of a female patient diagnosed with TCM based on clinical, laboratory, and imaging tests. Differentiating TCM from HCM was challenging due to ventriculography and echocardiography findings, as hyperdynamic contraction of the basal segments of the left ventricle caused an increased left ventricular outflow tract (LVOT) gradient and severe mitral valve regurgitation. Detailed evaluation and close echocardiographic follow-up are essential in such rare cases.