Peripheral Thromboembolism Formation in a Case of Takotsubo Cardiomyopathy

Takotsubo cardiomyopathy (TC) is a reversible cardiac disorder of the elderly commonly seen in postmenopausal women. TC can present similar to acute coronary syndrome with chest pain and dyspnea; however, there is no coronary artery occlusion. Patients with TC classically show ventricular apical ballooning and hypokinesis on echocardiogram. Few cases of thromboembolism of the lower extremity due to Takotsubo have been reported in the literature. Here, we report a unique occurrence of a thromboembolism formation in the right common iliac and external iliac arteries in the context of TC. Through the mechanisms of TC that involve ventricular wall abnormalities, hypercoagulability, and catecholamine excess, thromboembolism in the iliac system was likely from the akinetic ventricle. In this case, computed tomography angiography was an essential diagnostic tool that revealed the peripheral occlusion; therefore, it should be considered in patients with a history of TC who complain of lower extremity pain and neurological symptoms.