A DIAGNOSIS WITHOUT EXCLUSION: REVERSE TAKOTSUBO IN A 26-YEAR-OLD FEMALE

Document Type

Conference Proceeding

Publication Date

4-1-2024

Publication Title

J Am Coll Cardiol

Abstract

Background Takotsubo cardiomyopathy is a diagnosis of exclusion that typically requires a left heart catheterization. Reverse takotsubo has a prevalence of approximately 2% of all takotsubo cardiomyopathies. Case A 26-year-old female with no past medical history presented for elective bilateral salpingectomy. Intra-operatively, the patient became bradycardic and suffered a cardiac arrest. She was resuscitated but was found to be in shock. CT angiogram of the chest was negative for pulmonary embolism and showed diffuse pulmonary edema. Echocardiogram showed an ejection fraction (EF) of 15-20% with akinesis of the basal-mid anterior, inferior, anteroseptal, inferoseptal and lateral wall (figure 1). The patient improved with inotropic support and diuresis. Repeat echocardiogram, four days later, showed improvement of EF to 45%. She was placed on guideline-directed medical therapy and EF recovered 1 month after presentation. [Formula presented] Decision-making The multiple regions of akinesis with preserved apical contraction seen on echocardiogram do not fit a coronary territory, and thus these findings are incompatible with a coronary pathology. The diagnosis of reverse takotsubo was made without the use of a left heart catheterization given the patient's clinical presentation, characteristic imaging findings, and rapid normalization of wall motion abnormalities. Conclusion We present a case of reverse takotsubo in a 26-year-old female where the diagnosis was made conclusively by echocardiogram.

Volume

83

Issue

13

First Page

3582

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