Vertebral Compression Fracture in Takotsubo Cardiomyopathy

Takotsubo cardiomyopathy is often triggered by an intense physical or emotional event ; it is rarely seen in patients with spinal disease. We experienced a case of takotsubo cardiomyopathy triggered by a vertebral compression fracture. A 75-year-old woman was admitted to our hospital with complaints of low back pain that developed after a fall. X-ray and computed tomography images revealed an L1 vertebral compression fracture. Magnetic resonance imaging demonstrated a fresh fracture on the L1 vertebral body. She was treated conservatively ; however, as her low back pain worsened, balloon kyphoplasty (BKP) was planned. Pre-operative electrocardiography demonstrated ST elevation in multiple leads, and transthoracic echocardiography revealed ventricular asynergy. Acute coronary syndrome was suspected, and an urgent coronary angiography was performed. There was no coronary artery stenosis, but akinesis of apical wall was detected. The patient was diagnosed with takotsubo cardiomyopathy without chest pain or dyspnea. She had an uneventful course without cardiac complications, such as cardiac failure and arrhythmia. BKP was performed safely, after which her low back pain was relieved. She was discharged on the 27th postoperative day.