Case Report: Stepwise noninvasive diagnosis of Takotsubo cardiomyopathy in an elderly patient-From ECG clues to echocardiographic and CTA confirmation.

IF 2.8 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Frontiers in Cardiovascular Medicine Pub Date : 2025-06-04 eCollection Date: 2025-01-01 DOI:10.3389/fcvm.2025.1608992

Yanling Teng, Xingxing Sun, Minglang Wang, Ziyang Wang, Yilian Wang

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引用次数: 0

Abstract

Background: Takotsubo cardiomyopathy (TTC) is frequently misdiagnosed as acute coronary syndrome in elderly patients. This case demonstrates how ECG findings facilitate a noninvasive diagnostic algorithm for TTC, validated by echocardiography and coronary computed tomography angiography (CCTA).

Case summary: An 88-year-old woman presented with chest tightness and dyspnea after emotional stress (bereavement). Initial ECGs showed the concurrent appearance of ST-segment elevations in anterior (V3-V5) and inferior leads (II, III, aVF), suggesting apical injury and the diagnosis of TTC. Bedside echocardiography revealed apical akinesis with preserved basal contraction (LVEF 35%), while CCTA ruled out obstructive disease. Supportive therapy led to symptom resolution. At 1-year follow-up, LVEF recovered to 61% with normalized ECG.

Conclusion: This case highlights ECG's pivotal role in suspecting TTC, enabling a Noninvasive diagnostic approach (echocardiography + CCTA) for elderly patients.

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病例报告：老年Takotsubo型心肌病的逐步无创诊断——从心电图提示到超声心动图和CTA确认。

背景：老年Takotsubo心肌病（TTC）常被误诊为急性冠脉综合征。本病例通过超声心动图和冠状动脉ct血管造影（CCTA）验证了心电图结果如何促进TTC的无创诊断算法。病例总结：一名88岁女性在情绪紧张（丧亲之痛）后出现胸闷和呼吸困难。初始心电图显示前导联（V3-V5）和下导联（II， III, aVF）同时出现st段升高，提示尖端损伤，诊断TTC。床边超声心动图显示根尖运动并保留基底收缩（LVEF 35%），而CCTA排除阻塞性疾病。支持性治疗导致症状缓解。随访1年，心电图恢复正常，LVEF恢复到61%。结论：本病例强调了ECG在怀疑TTC中的关键作用，为老年患者提供了无创诊断方法（超声心动图+ CCTA）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine

CiteScore

3.80

自引率

11.10%

发文量

3529

审稿时长

14 weeks

期刊介绍： Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.