Why the study?
Diagnosis and management are challenging when Takotsubo syndrome presents with atypical symptoms and significant obstructive coronary artery disease.
Case Report (n=1)
No
This case highlights that the presence of obstructive coronary artery disease does not exclude the diagnosis of Takotsubo cardiomyopathy, and ad hoc PCI may be a reasonable management strategy for coexisting lesions.
Diagnosis of Takotsubo remains challenging with obstructive CAD; case reports leave open questions on optimal management.
Background. Takotsubo is a syndrome characterized by transient regional systolic dysfunction of the left ventricle (LV). The most common clinical presentation mimics acute myocardial infarction without angiographic evidence of obstructive coronary artery disease or acute plaque rupture.1-3 The diagnosis and management became a challenge when it presented as atypical symptoms and significant obstructive coronary artery. Thus, this case report highlights the diagnosis and management of Takotsubo Cardiomyopathy with obstructive coronary artery disease.Case illustration. A 71 years old woman came to the emergency room with a chief complaint of dyspnea from one week ago and worsened in the last three days. The initial electrocardiogram showed slight ST-elevation, and thorax Rontgen showed the congestion and elongation of the aorta. Increased high-sensitive Cardiac Troponin T and The NT-Pro BNP levels were present, along with apical ballooning of the LV and reduced RV function. Physiological stress was found to be the death of her husband one week ago. Although the left ventriculography of this patient was classically depicted as the octopus trap, we did find obstructive coronary artery disease in the left anterior descending artery.
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Juzar et al. (2023) conducted a case report in Takotsubo Cardiomyopathy with obstructive coronary artery disease (n=1). Ad hoc percutaneous coronary intervention (PCI) and medical therapy was evaluated on Clinical recovery and resolution of apical ballooning.
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