This case highlights that left ventricular rupture can be a rare but fatal complication of takotsubo-like left ventricular dysfunction, potentially associated with abnormal Q waves, increased CK, and systolic anterior motion of the mitral valve.
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May warrant vigilance for rupture in takotsubo-like LV dysfunction; leaves open whether ECG or echo features predict it.
A 71-year-old woman was admitted with sudden-onset shoulder and back pain. The electrocardiograph showed sinus rhythm with ST-segment elevation in leads V4-6 and abnormal Q waves in leads V4-5. Echocardiography at the time of admission revealed akinesis in the left ventricular apical wall. However, coronary angiography did not reveal a stenotic lesion in any of the coronary arteries. Left ventriculography revealed apical ballooning with basal hyperkinesis. Ten hours after onset, the patient suddenly collapsed and went into cardiopulmonary arrest. This is a rare case of left ventricular rupture with takotsubo-like left ventricular dysfunction.
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Yamada et al. (2006) studied this question.
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