Echocardiographic Diagnosis of Ventricular Free Wall Rupture Complicating Takotsubo Syndrome: A Case Report

Figure 1. Brain MRI and angiographic findings. (A) Diffusion-weighted imaging demonstrating acute infarction in the right parietal lobe (arrow). (B) Fluid-attenuated inversion recovery imaging showing corresponding hyperintensity in the same region (arrow). (C) Magnetic resonance angiography revealing no significant large-vessel occlusion.

Figure 2. Electrocardiographic changes from admission to hospital day six. (A) Electrocardiogram on admission (day one) showing ST-segment abnormalities in the precordial leads. (B) Electrocardiogram on day six demonstrating dynamic changes with partial resolution of ST abnormalities.

Figure 3. Left ventriculography showing apical ballooning. Left ventriculography demonstrated wall motion abnormalities extending beyond a single coronary artery territory, with akinesis of the mid-to-apical segments and basal hyperkinesis, consistent with Takotsubo syndrome.

Figure 4. Transthoracic echocardiography showing pericardial effusion with fibrinous strands. Transthoracic echocardiography demonstrating pericardial effusion surrounding the left ventricle with echogenic fibrinous strands, consistent with organized hemopericardium associated with ventricular free wall rupture. Arrows indicate fibrinous echoes within the pericardial effusion adjacent to the left ventricular free wall.