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A rare ventriculography: midventricular Takotsubo Syndrome

  • Author Footnotes
    # Both authors contributed equally to this article.
    Raquel Menezes Fernandes
    Correspondence
    Corresponding Author: Rua Leão Penedo 8000-386, Tel: +3519671812.
    Footnotes
    # Both authors contributed equally to this article.
    Affiliations
    Cardiology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal

    Algarve Biomedical Center, Universidade do Algarve, Faro, Portugal
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  • Author Footnotes
    # Both authors contributed equally to this article.
    Teresa Faria da Mota
    Footnotes
    # Both authors contributed equally to this article.
    Affiliations
    Cardiology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal

    Algarve Biomedical Center, Universidade do Algarve, Faro, Portugal
    Search for articles by this author
  • Author Footnotes
    # Both authors contributed equally to this article.
Published:October 22, 2022DOI:https://doi.org/10.1016/j.amjms.2022.10.009
      A 65-year-old woman was transferred to our Cardiology Department due to a syncope in the sitting position, without prodromes and with mandibular trauma, after a 30-minute walk. Apart from dyslipidemia, she had no other cardiovascular risk factors, being physically active. She was under emotional stress due to her father's recent death. Physical examination was unremarkable except for a small bruise on the jaw. First electrocardiogram showed sinus tachycardia, 120/min, 1 mm ST-elevation in aVL and a less than 1 mm ST-depression in the inferior leads. Troponin T was elevated (maximum value of 519 pg/ml; reference value of <14 pg/ml). Transthoracic echocardiogram showed a mild depression on the left ventricular (LV) systolic function (LV ejection fraction of 45%) with severe hypokinesia of all midventricular segments. Coronariography revealed no significant coronary lesions and ventriculography unveiled an akinesia of all LV median segments, with preserved contractility of basal and apical segments (Figure 1), compatible with the diagnosis of the midventricular variant of Takotsubo Syndrome (TTS). She initiated medical therapy and had no complications during hospitalization. She was discharged medicated with bisoprolol 2,5 mg, ramipril 2,5 mg and atorvastatin 40 mg.

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      References

        • Pestana G
        • Tavares-Silva M
        • Sousa C
        • et al.
        Myocardial dysfunction in Takotsubo syndrome: More than meets the eye?.
        Rev Port Cardiol. 2019; 38: 261-266https://doi.org/10.1016/j.repc.2018.07.008
        • Rawish E
        • Stiermaier T
        • Santoro F
        • et al.
        Current knowledge and future challenges in takotsubo syndrome: Part 1—pathophysiology and diagnosis.
        J Clin Med. 2021; 10: 1-23https://doi.org/10.3390/jcm10030479
        • Ghadri JR
        • Wittstein IS
        • Prasad A
        • et al.
        International Expert Consensus Document on Takotsubo Syndrome (Part II): Diagnostic Workup, Outcome, and Management.
        Eur Heart J. 2018; 39: 2047-2062https://doi.org/10.1093/eurheartj/ehy077