Key result
A 78-year-old woman presented with an atypical, delayed clinical presentation of Tako-tsubo-like syndrome following a strong emotional stress event.
Case Report (n=1)
Highlights the possibility of Tako-Tsubo syndrome presenting atypically with a delayed onset after an emotional stress event.
Alerts clinicians to atypical regional akinesia with mild necrosis; leaves open mechanisms and diagnostic criteria in elderly women.
A 78-year-old woman presented herself at emergency for the appearance of severe dyspnea. An electrocardiogram showed signs of inferior and anterior necrosis, and laboratory tests showed a small increase of myocardial cytonecrosis enzymes. An echocardiogram detected a reduction of global systolic function (ejection fraction [EF] approximately 40%) as well as akinesia of the apex, interventricular septum middle segments, and anterior and anterolateral walls, with basal segments showing compensatory hyperkinesia. The coronarography showed a coronary tree substantially free from significant lesions. The patient was transferred to the cardiology unit of our hospital. Based on the contained increase of the cardiac enzymes, the absence of coronary lesions, and the presence of typical echocardiography alterations, we suspected a Tako-tsubo-like syndrome. On deeper anamnestic investigation, an event of strong emotional stress emerged preceding the hospital admission that confirmed the pathology, even though it is atypical to see clinical presentation a long time after a stressful event.
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Ripa et al. (2008) conducted a case report in Tako-Tsubo-Like Syndrome (n=1). Emotional stress was evaluated. A 78-year-old woman presented with an atypical, delayed clinical presentation of Tako-tsubo-like syndrome following a strong emotional stress event.
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