Midventricular form of takotsubo cardiomyopathy as a recurrence 1 year after typical apical ballooning: a case report

Abstract

Takotsubo cardiomyopathy was first described in Japan and is characterized by transient left ventricular apical ballooning in the absence of a significant coronary artery disease.Caused by the clinical presentation including chest pain, electrocardiographic changes and elevated myocardial markers this syndrome is frequently misdiagnosed as an acute coronary syndrome. Recurrences of Takotsubo Cardiomyopathy, especially in variant regions of the left ventricle are rareWe describe a midventricular form of Takotsubo Cardiomyopathy as a recurrence 1 year after typical apical ballooning.

Recurrent takotsubo cardiomyopathy can appear as transient midventricular ballooning syndrome

“…Although recurrence of takotsubo cardiomyopathy is known to be rare [3], there are some reports of recurrent cases showing atypical patterns of left ventricular contraction. Furthermore, there are cases similar to the one reported here, in which good contractions of the apex and base have been observed during the second attack [4,5]. Transient midventricular ballooning syndrome has been described as an atypical form of takotsubo cardiomyopathy [6] and our case at the second admission can be classified into this syndrome.…”

Takotsubo Syndrome and Inflammatory Bowel Diseases: Does a Link Exist?

“…However, literature data are extremely few. To the best of our knowledge, there are only 13 case reports (Tables 2, 3) describing the occurrence of TTS in IBD patients [26][27][28][29][30][31][32][33][34][35][36][37][38]. Interestingly, the totality of reported TTS occurred in female IBD patients.…”

“…As well as for TTS patients [17,39], the prevalence of affective disorders is high among IBD patients, particularly among female [18]. Besides the well-known role played by excessive catecholamine release in triggering TTS [26], such as in pheochromocytoma [27], IBD patients, and particularly CD patients, could show disease-specific triggers.…”

“…Mengoni et al [25] emphasize the role of disease exacerbation with consequent activation of inflammatory patterns and microvascular dysfunction [29]. According to Zegdi et al [23] and to Tagami et al [26], depression and affective disorders could represent specific triggers [27,30]. Interestingly, 4 out of 9 CD patients presenting with TTS were on treatment with corticosteroids and 5 out of 9 were affected by active CD (Table 2).…”

Very Late Recurrence of Takotsubo Syndrome

“…The Takotsubo syndrome has been recently classified as a form of cardiomyopathy, and in most cases involves females in post‐menopause 3 . Recurrence of Takotsubo is possible, 4 and in the majority of cases occurs within 4 years 5–8 ; the present report is focused on a case of Takotsubo syndrome recurrence after 10 years.…”