Key result
Surgical resection of a left ventricular pseudoaneurysm and defect closure successfully treated a 63-year-old woman with left ventricular wall rupture secondary to reverse type Takotsubo cardiomyopathy.
Case Report (n=1)
No
Reverse type of Takotsubo cardiomyopathy can be complicated by life-threatening left ventricular wall rupture, which can be successfully managed with surgical repair.
Alerts clinicians to rare LV rupture risk in reverse Takotsubo; leaves open optimal management beyond this single case.
OBJECTIVE: We present the case of possible reverse type of TCM in a female patient presented with progressive left ventricular dysfunction and its rupture in pericardium. METHODS: The detailed history, physical examination, laboratory tests, electrocardiography, serial echocardiography, coronary angiography with left ventriculography were performed to diagnose possible Takotsubo cardiomyopathy in 63-year old woman admitted to our center with complaints of dyspnea, lightheadedness, weakness and signs of hypotension and history of inferior myocardial infarction, acute left ventricular aneurysm, and effusive pericarditis and pleuritis, developed after emotional stress 5 months ago. RESULTS: Clinical evaluation revealed unremarkable laboratory tests, normal troponin values, signs of old inferior myocardial infarction on electrocardiogram, and left ventricular (LV) dilatation and dysfunction, akinesia of LV infero-lateral wall with thinning and its rupture and blood shunting in pericardium. Her coronary angiography revealed normal coronary arteries. The diagnosis of pheochromocytoma was excluded. The patient underwent surgery under cardiopulmonary bypass with removal of LV pseudoaneurysm. The patient was discharged from hospital with improvement in NYHA class and LV function. CONCLUSION: Thus, in female postmenopausal patients presenting with acute myocardial infarction signs complicated by pericarditis, intact coronary arteries and LV dysfunction with emotional stress as triggering factor, reverse type of TCM should be considered and proper management applied to prevent development of life-threatening complications like LV rupture.
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Kudaiberdiev et al. (2017) conducted a case report in Takotsubo cardiomyopathy with left ventricular wall rupture (n=1). Surgical resection of LV pseudoaneurysm and closure of LV posterior wall defect was evaluated on Clinical recovery and LV function improvement. Surgical resection of a left ventricular pseudoaneurysm and defect closure successfully treated a 63-year-old woman with left ventricular wall rupture secondary to reverse type Takotsubo cardiomyopathy.
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