Takotsubo cardiomyopathy – rare cause of acute heart failure or even death?

Introduction: Takotsubo Cardiomyopathy, also known as „Broken-Heart Syndrome“, is a heart disease with unknown etiology, which based on clinical, electrocardiographic, ultrasound and enzymatic presentation mimics acute coronary syndrome. According to a basis of ballooning pattern Takotsubo is classified into clinical groups: Takotsubo type (apical akinesia and basal hypercontraction), mid ventricular type, inverse type (basal akinesia and apical hypercontraction), and localized type.
Cases presentation: We present 2 clinical cases diagnosed and monitored in our clinic, respectively 2 female patients with undocumented cardiovascular history: one young patient with LBBB and unstable angina, with normal coronary artery at coronarography, identified aș type II, and another one with postpartum acute heart failure, with normal coronary artery at mulți slices CT128, identified as type III according to diagnostic criteria for Takotsubo’s disease. For the diagnosis to be confirmed according to Mayo Clinic four main criteria must be fulfilled: typical left ventricle contraction pattern, absence of obstructive coronary artery disease, dynamic electrocardiographic or enzymatic changes in patients without pheochromocytoma or myocarditis. For conformation on use the cardiac MRI examination. Our first case with atypically presentation, unstable angina and intermittent LBBB on ECG, with apical segmental systolic dysfunction and normal coronarography, cardiac MRI was the way to the Takotsubo cardiomyopathy diagnostic. Regarding the patient with Acute Heart Failure five hours postpartum, with severe mitral regurgitation, multislice angio CT was the way to provide normal coronary arteries and to rule out pulmonary thromboembolism, the most frequent severe cardiovascular complication postpartum.
Conclusions: Takotsubo cardiomyopathy is a disease with unpredictable onset and evolution, which can be suggested by echocardiographic presentation and confirmed using more complex investigations such as co-ronarography and cardiac MRI.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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