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Tako-tsubo cardiomyopathy: findings on cardiac CT and coronary catheterisation
  1. J W Nance1,2,
  2. U J Schoepf1,2,
  3. L Ramos-Duran1,2
  1. 1Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
  2. 2Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
  1. Correspondence to U Joseph Schoepf, Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Drive, MSC 226, Charleston, SC 29401, USA; schoepf{at}musc.edu

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An elderly subject (age 70s) without previous cardiac history but whose spouse had recently died, presented with acute chest pain. Cardiac CT was performed, which revealed normal coronary arteries (panel A). However, functional analysis showed left ventricular (LV) apical hypokinesis with systolic ballooning (panel B, online video 1) prompting a diagnosis of tako-tsubo cardiomyopathy. Echocardiography 12 h later demonstrated interim formation of a LV apical thrombus. Subsequent left heart catheterisation again showed normal coronary arteries and persistent LV apical hypokinesis with systolic ballooning (panel C, online video 2). On day 3, the patient was clinically stable and discharged under anticoagulation. Follow-up echocardiography 1 week later showed resolution of the thrombus and normalisation of cardiac function. This case illustrates the classic presentation, imaging findings and clinical course of tako-tsubo cardiomyopathy with new-onset heart failure in the absence of coronary artery disease in the context of emotional stress (“broken heart syndrome”) followed by rapid recovery.1 2

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Footnotes

  • Competing interests UJS is a medical consultant for and receive research support from Bayer-Schering, Bracco, General Electric, Medrad and Siemens.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

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