Key result
Multimodality imaging identifies preserved-EF Takotsubo syndrome with dynamic LVOT obstruction and apical strain dissociation.
Why the study?
Takotsubo syndrome may mimic acute coronary syndrome even when global systolic function is preserved, requiring multimodality imaging in the diagnostic work-up.
Case Report (n=1)
This case report demonstrates the utility of multimodality imaging, particularly echocardiography and speckle-tracking, in diagnosing Takotsubo syndrome with dynamic left ventricular outflow tract obstruction even when left ventricular ejection fraction is preserved.
Answers are grounded in this paper and cite their sources.
Echocardiography may aid differentiation of preserved-EF Takotsubo from ACS; hypothesis-generating and requires prospective validation.
Takotsubo syndrome may mimic acute coronary syndrome even when global systolic function is preserved. A 77-year-old postmenopausal woman presented with exertional chest pain, presyncope, hypotension, mild lateral ST-segment elevation, and transient high-sensitivity troponin T elevation. Coronary angiography showed nonobstructive coronary arteries. Transthoracic echocardiography demonstrated preserved left ventricular ejection fraction, circumferential apical dysfunction, basal hypercontractility, moderate mitral regurgitation, and dynamic left ventricular outflow tract obstruction caused by chordal systolic anterior motion. Speckle-tracking showed apical–basal strain dissociation despite preserved ejection fraction. Cardiac magnetic resonance provided tissue characterization, showing no acute myocardial edema, infarct-pattern scar, perfusion defect, or microvascular obstruction, while follow-up echocardiography demonstrated recovery of regional wall motion and mitral regurgitation. This case highlights multimodality imaging in the diagnostic work-up of Takotsubo syndrome, with echocardiography providing decisive diagnostic and hemodynamic information.
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Tommy et al. (2026) conducted a case report in Preserved-ejection-fraction Takotsubo syndrome with dynamic left ventricular outflow tract obstruction mimicking acute coronary syndrome (n=1). Multimodality imaging (transthoracic echocardiography, speckle-tracking, cardiac magnetic resonance) was evaluated on Diagnostic characterization and recovery of regional wall motion and mitral regurgitation. Multimodality imaging diagnosed preserved-EF Takotsubo syndrome with dynamic LVOT obstruction and apical-basal strain dissociation in a 77-year-old woman (n=1), with full recovery on follow-up.
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