The aim of the study is to present clinical case report of Takotsubo cardiomyopathy, improve knowledge and diagnostic capabilities of this syndrome.
Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy is a syndrome generally characterized by transient systolic dystunction of the left ventricle, that mimics myocardial infarction, but in the absence of significant coronary artery disease, and is often triggered by acute emotional or physical stress. Takotsubo cardiomyopathy is much more common in women than men, where catecholamines and estrogens play an important role in the pathogenesis. Diagnostic and treatment is supported mainly by early and well-timed percutaneous coronary intervention and cardiovascular magnetic resonance imaging. In addition to accurate visualization of regional wall motion abnormalities, cardiovascular magnetic resonance imaging allows for precise quantification of right ventricular and left ventricular function and the assessment of additional abnormalities, such as pericardial or pleural effusion, thrombi in the heart chambers. Takotsubo cardiomyopathy is accurately identified by cardiovascular magnetic resonance imaging using specific diagnostic criteria: a typical pattern of left ventricular dysfunction, myocardial edema, markers for myocardial inflammation and absence of significant necrosis or fibrosis. Recently, positron emission tomography is described as an alternative way to diagnose Takotsubo cardiomyopathy. Patients undergoing myocardial positron emission tomography have identified a discrepancy between normal perfusion and reduced glucose utilization in dysfunction regions, known as an inverse flow metabolism mismatch and represents a transient metabolic disorder in the cellular level. Nevertheless, prognosis is good, with full recovery of cardiac function within 2-4 weeks in most of the cases. This article describes a clinical case of a 58 years old woman with typical Takotsubo cardiomyopathy, that occurred after sudden emotional stress.
