Takotsubo cardiomyopathy in a man with no trigger and multiple cardioembolic complications-A rare constellation

Echocardiography. 2019 May;36(5):975-979. doi: 10.1111/echo.14333. Epub 2019 Apr 7.

Abstract

Takotsubo Cardiomyopathy (TC) is an uncommon, transient, reversible cardiomyopathy, with a classic pattern of wall-motion abnormalities, usually seen in women after an emotional stressor. Despite its increased recognition, there remain gaps in the exact mechanisms, predisposing factors, and predictors of recovery; this is particularly true for males where the condition occurs far less frequently than in females. TC typically resolves within weeks, and the prognosis is favorable compared to acute coronary syndromes. Nonetheless, about 1% of cases may be complicated by left ventricular (LV) thrombus and embolism. Herein we describe an atypical case of a man with no obvious trigger, who developed TC with left ventricular thrombus and multiple embolic complications, but subsequently showed complete and full resolution. Multimodality imaging including echocardiography, cardiac CT and cardiac MRI was instrumental in this diagnostic dilemma, as well as useful in guiding treatment options and informing prognosis.

Keywords: cardiac CT; cardiac MRI; cardiomyopathy; echocardiography; takotsubo.

Publication types

  • Case Reports

MeSH terms

  • Coronary Thrombosis / complications*
  • Coronary Thrombosis / diagnostic imaging*
  • Coronary Vessels / diagnostic imaging
  • Diagnostic Imaging / methods*
  • Echocardiography / methods
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Takotsubo Cardiomyopathy / complications*
  • Takotsubo Cardiomyopathy / diagnostic imaging*
  • Tomography, X-Ray Computed / methods