Key result
Mid-ventricular takotsubo syndrome shows T-wave inversion sparing V3-V4 linked to localized mid-ventricular edema.
Case Report (n=1)
This case reinforces the theory that the regional distribution of acute myocardial inflammation in takotsubo syndrome correlates with dynamic repolarization changes on ECG.
Supports ECG-edema correlation in mid-ventricular takotsubo; hypothesis-generating and requires validation before clinical use.
Previous studies showed that myocardial edema correlates with dynamic T-wave inversion and QTc prolongation in a variety of acute cardiovascular diseases including takotsubo syndrome (TTS). We reported the case of a patient with "atypical" (mid-ventricular) TTS showing a unique pattern of diffuse T-wave inversion that spared only the apical precordial leads V3-V4. Cardiac magnetic resonance (CMR) showed myocardial edema involving all mid-ventricular segments but not the apex. Both ECG and CMR normalized at follow-up evaluation. This case further reinforces the theory of an association between presence and regional distribution of acute myocardial inflammation and dynamic repolarization changes.
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Giannattasio et al. (2021) conducted a case report in mid-ventricular takotsubo syndrome (n=1). A patient with mid-ventricular takotsubo syndrome showed diffuse T-wave inversion sparing apical leads V3-V4, correlating with myocardial edema in mid-ventricular segments but not the apex.
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