Reverse Takotsubo syndrome diagnosed with Tc-99m SPECT perfusion study

Davis, Michael; Hardebeck, Charles J.

doi:10.1007/s12350-009-9089-6

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…Cardiac nuclear imaging findings in atypical variants of TTC reflect literature data published for the typical apical form, but with different distribution patterns of uptake defects. In particular, the analysis of the selected papers showed normal perfusion in most publications, with a mild reduction reported only in a minority of papers [70][71][72][73][74][75][76][77][78][79][80][81][82][83][84], always followed by complete normalization on follow-up studies when performed [75][76][77]. Perfusion G-SPECT confirmed the presence of motion and thickness abnormalities, associated with a reduction in LVEF during the acute phase, in accordance with echocardiographic findings [72].…”

Section: Discussion and Limitationssupporting

confidence: 60%

“…Myocardial scintigraphy with 99mTc-sestamibi was performed as a single cardiac nuclear imaging modality to assess the left ventricular perfusion in the remaining two publications. A fixed midventricular and basal circumferential area of hypoperfusion and hypokinesis with preservation of the ventricular apex was revealed during a rest-stress dipyridamole Tc-99m sestamibi myocardial perfusion G-SPECT by Davis and coworkers [84] in a 49-yearold black male admitted to the intensive care unit with acute respiratory failure with anoxic encephalopathy and elevated cardiac biomarkers. In this case, as the anatomical distribution of the specific perfusion defects did not appear to represent obstructive epicardial coronary pathology, immediate coronary angiography was not performed and a final diagnosis of atypical stress-induced cardiomyopathy was made.…”

Section: Cardiac Nuclearmentioning

confidence: 98%

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Cardiac Nuclear Imaging Findings in Atypical Variants of Takotsubo Cardiomyopathy

De Feo,

Conte,

Frantellizzi

et al. 2024

Applied Sciences

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Background: In addition to the typical form resembling the classical Japanese octopus trap, atypical variants of Takotsubo cardiomyopathy (TTC) sparing the left ventricular apex have emerged over the years. The aim of this systematic review is to provide a comprehensive overview of the cardiac nuclear imaging findings in atypical variants. Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The literature research was carried out online on the Pubmed, Scopus, Central (Cochrane Library), and Web Of Science databases. Results: A total of 14 articles were ultimately selected. Myocardial perfusion scintigraphy was performed in nine studies, followed by 123I-mIBG scintigraphy, 123I-BMIPP scintigraphy, and 18F-FDG PET. In seven cases, a single cardiac nuclear imaging technique was performed, while in the remaining five and two cases, two and three different imaging modalities were, respectively, used. The most common atypical variant of our selection was the midventricular form, followed by reverse/inverted/basal TTC, with only a single case reported of a focal pattern. Conclusions: As the reason why TTC variants occur is still not clear, a deeper understanding of the current knowledge could be the basis for providing more insights into this fascinating disorder and its uncommon manifestations.

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Section: Discussion and Limitationssupporting

confidence: 60%

Section: Cardiac Nuclearmentioning

confidence: 98%

Cardiac Nuclear Imaging Findings in Atypical Variants of Takotsubo Cardiomyopathy

De Feo,

Conte,

Frantellizzi

et al. 2024

Applied Sciences

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“…In a few reports, mid-ventricular ballooning diagnosed with 99m Tc-Tf perfusion study demonstrated myocardial perfusion abnormality was limited in narrow basal and mid-ventricular area and maintained almost normally in the apical area [5,7,8]. Similarly, previously diagnosed mid-ventricular ballooning in our hospital demonstrated moderately reduced perfusion in the small area of the mid-ventricle using 99m Tc-Tf study (Fig.…”

Section: Discussionsupporting

confidence: 58%

Atypical morphology and myocardial perfusion of mid-ventricular ballooning: A case report

Maeba

Kanazawa

Tsujimoto

et al. 2012

Journal of Cardiology Cases

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Although some atypical types of transient left ventricular apical ballooning syndrome have been reported, only a few atypical types of transient mid-ventricular ballooning have been reported. A 70-year-old female underwent surgery for urothelial carcinoma. At day 5 after the surgery, she was admitted to our department without cardiac symptoms because of ST elevation in leads I, II, III, aVF and V1-V6 indicating acute coronary syndrome. She was diagnosed with stress induced cardiomyopathy based on an angiographically normal coronary artery, newly developed extensive wall motion abnormality (hyperbasal contraction and akinesis from the mid-left ventricle to the apex without hypercontraction of the small area adjacent to the apex) based on left ventriculography, and a small elevation of myocardial enzymes incongruous with the area of contraction abnormality. Myocardial scintigraphy with 99m Tc-tetrofosmin showed a severely reduced myocardial perfusion in an extensive mid-ventricular area without a left ventricular base and top of apex, in accord with a wall motion abnormality different from typical apical ballooning or typical mid-ventricular ballooning previously diagnosed in our hospital. This is the first report presenting an atypical mid-ventricular ballooning based on the myocardial atypical perfusion findings.

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“…In fact, some reports have noted that myocardial perfusion may be completely normal despite significant wall motion abnor- malities and the presence of symptoms [7,8]. Although the perfusion abnormality in the apex can be partially explained by a partial volume effect involving the non-thickening apical segments [9,10], many studies have demonstrated that microvascular dysfunction may be responsible for a true perfusion defect [6,11,12]. Another tracer Tc-99mPYP, which has traditionally been used in the diagnosis and quantification of myocardial infarction, has also been used in the evaluation of TC.…”

Section: Discussionmentioning

confidence: 99%

Scintigraphic Evaluation of Takotsubo Cardiomyopathy

Lalude¹,

Gutarra²,

Abbas³

2011

TOCARIJ

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Abstract:The Takotsubo Cardiomyopathy (TC) also called broken heart syndrome, or stress-induced cardiomyopathy is characterized by the transient ballooning of the apex during systole as result of apical dyskinesia in conjunction with a compensatory hyperkinesia of the base of the left ventricle; in the absence of significant epicardial coronary artery disease. We report a case of TC with the characteristic findings of apical dyskinesia and perfusion abnormalities on gated SPECT which was diagnosed in retrospect after coronary angiography and left ventriculography. This is followed by a brief review of the scintigraphic techniques that have been used in the evaluation of TC. As TC accounts for at least 1-2% of presentations of acute coronary syndromes, increased awareness on the part of interpreting physicians is required for earlier diagnosis in the subset of patients referred for myocardial perfusion imaging.

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Reverse Takotsubo syndrome diagnosed with Tc-99m SPECT perfusion study

Cited by 8 publications

References 10 publications

Cardiac Nuclear Imaging Findings in Atypical Variants of Takotsubo Cardiomyopathy

Cardiac Nuclear Imaging Findings in Atypical Variants of Takotsubo Cardiomyopathy

Atypical morphology and myocardial perfusion of mid-ventricular ballooning: A case report

Scintigraphic Evaluation of Takotsubo Cardiomyopathy

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