Takotsubo cardiomyopathy: case report and review of the literature.

Abstract

Takotsubo cardiomyopathy, also known as stress induced cardiomyopathy and transient left ventricular apical ballooning syndrome, is a rare syndrome that is characterized by a transient decrease in ejection fraction. This is accompanied by hypokinesis of the left ventricle and ballooning of the apex, with hypercontractile base and non-obstructive coronary artery disease. Takotsubo was first described in Japan in the early 1990's. It was named such due to the morphology of the apical ballooning that is similar in shape to a 'takotsubo', which is a pot with a round bottom and narrow neck used for trapping octopuses. Though most often described in Asians, reports of Takotsubo in Caucasian populations is becoming more common, possibly due to heightened awareness and detection. The most common presenting symptom of Takotsubo is acute chest pain mimicking myocardial infarction. Patients may also present with dyspnea, pulmonary edema and, more rarely, cardiogenic shock. Clinical symptoms are accompanied by transient left ventricular dysfunction. Despite clinical symptoms consistent with acute myocardial infarction, normal coronary arteries are usually detected upon cardiac catheterization. The case presented here is of an Asian woman who developed symptoms of acute myocardial infarction during a stressful hospital stay.