Takotsubo T Waves---a Diagnostically Useful Electrocardiographic Pattern in 10 Case Presentations

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  Figure 1. (A-1–J-1) Ten electrocardiograms of 9 patients, all diagnosed with takotsubo cardiomyopathy. All (A) and (B) images are from the same patient, who presented with 2 occurrences of takotsubo cardiomyopathy 2 years apart. All patients were women, with an average age of 65 years at the time of presentation. Of the 10 admissions across 9 patients, 5 (50%) had an emotional trigger, 2 (20%) had a physical trigger, and 3 (30%) had no identifiable trigger. On cardiac catheterization, there was no coronary artery disease identified in 7 (70%) and only mild disease in 3 (30%), as shown in (A-2) through (I-2) and (A-3) through (I-2) and (A-3) through (I-3). Assessment of left ventricular function identified apical-type takotsubo cardiomyopathy in 8 (80%) of the presentations, whereas the remaining 2 (20%) were the midventricular type, as shown in (A-4) through (I-4) and (A-5) through (I-5). Coronary and left venticular imaging was not available for patient J.