Published in:
01-12-2014 | Images in CV Applications
Recurrent mid-ventricular takotsubo cardiomyopathy
Published in: The International Journal of Cardiovascular Imaging | Issue 8/2014
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A 65-year-old woman was admitted for acute chest pain after choking on water. Coronary angiography revealed no obstructive coronary artery disease. Left ventriculogram demonstrated mid-ventricular akinesis with basal and apical hyperkinesis (Fig. 1a, b, video 1). The next day, cardiovascular magnetic resonance (CMR) imaging was performed. CMR demonstrated myocardial edema in the area of left ventricular wall motion abnormality (Fig. 1c) and no late gadolinium enhancement. Left ventricular ejection fraction by CMR was 52 % (video 2, 3). Echocardiogram on day 5 demonstrated complete recovery of the wall motion abnormality. Angiotensin II receptor blocker and statin were initiated during hospitalization, but discontinued due to an unspecified cause after discharge. Follow-up CMR at 5 months revealed no myocardial edema. Left ventricular ejection fraction was 72 %.
Fig. 1
Left ventriculogram (LVG) and cardiovascular magnetic resonance imaging (CMR). Top row shows mid-ventricular ballooning on LVG (a, b), and myocardial edema matching the distribution of wall motion abnormality on CMR (c, arrows) in the first episode. Bottom row shows almost same findings in the recurrent episode (d, e, f)
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