Case Report
A Unique Case of Recurrent Takotsubo Cardiomyopathy
Abstract
Takotsubo (stress induced) cardiomyopathy is also known as broken heart syndrome or transient left ventricular apical ballooning syndrome. The clinical presentation, which mimics acute myocardial infarction, is preceded by intense emotional or physical stress. Recurrence of apical ballooning syndrome seems to be rare. We present a case of recurrent takotsubo cardiomyopathy precipitated by relatively mild physical stress. There was full recovery with conservative management. This suggests that there are presently unknown patient-specific characteristics that predispose patients to takotsubo cardiomyopathy.
Key Points
* Takotsubo cardiomyopathy presents similarly to acute coronary syndrome.
* The clinical manifestations and echocardiography abnormalities are out of proportion to the degree of elevation in cardiac enzymes.
* Complete recovery is almost a rule and recurrence is rare.
* Its association with physical or emotional stress suggests that this disorder may be caused by a diffuse catecholamine-induced microvascular spasm or dysfunction resulting in myocardial stunning.
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