A case of biventricular involvement of Takotsubo cardiomyopathy: 3D echocardiographic imaging

Excerpt

An 86-year-old woman was admitted to our institution exhibiting drowsy mentality due to hyperkalemia. Electrocardiography revealed symmetric T wave inversions at the anterior, inferior, and lateral leads (Fig. 1a). Three-dimensional echocardiography (iE33 xMATRIX with X5-1 transducer, QLAB software analysis using Cardiac 3D Quantification Advanced; Philips, Eindhoven, The Netherlands) revealed akinetic apical segments and hyperkinetic basal segments of the left ventricle (Fig. 1b, Video 1 in Supplementary Material) and dyskinetic apical segments of the right ventricle with a mildly decreased biventricular ejection fraction (Fig. 1c, Video 2 in Supplementary Material). Her coronary angiogram was normal. After 3 weeks, follow-up echocardiography showed normal wall motion and a good ejection fraction of the biventricle. Biventricular involvement of Takotsubo cardiomyopathy is not uncommon if close attention is paid to right ventricular function [1‐3]. Three-dimensional echocardiography is a useful tool to detect right ventricular involvement of Takotsubo cardiomyopathy and to estimate its function and morphology at the same time as assessing left ventricle.

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