ARYA Atherosclerosis Journal

A rare case of takotsubo syndrome led to intra-myocardial dissection and left ventricular apical aneurysm

Document Type : Case Report

Authors

Reihaneh Zavar 1
Mehrbod Vakhshoori 2
Mohsen Mirmohammadsadeghi 3
Mohammad Hashemi-Jazi 4

1 Assistant Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

2 General Practitioner, Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Assistant Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

4 Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medicine Sciences, Isfahan, Iran

https://doi.org/10.22122/arya.v15i1.1885
Abstract
BACKGROUND: Takotsubo syndrome (TS) is a reversible left ventricular (LV) systolic dysfunction occurred mostly in post-menopausal women after an emotional or physical stress. The exact mechanism has yet to be found. In clinical settings, TS should be differentiated from myocardial infarction (MI) due to totally different management protocols. Several diagnostic criteria are available, but mayo clinic criteria is the most widely used. Prognosis of TS is favorable and the recurrence and mortality rates are low. Treatment is mostly supportive and after a few weeks, most of patients’ electrocardiography (ECG) and echocardiographic findings will be normalized, though to its benign course, TS can cause some complications. Intra-myocardial dissection and LV apical aneurysm, as a complication of TS has never been reported yet and was just announced in rare cases of MI.CASE REPORT: Our patient was a 32-year-old aphasic woman referring with palpitation and chest discomfort. Further examinations after exclusion of MI revealed TS leading to LV apical aneurysm and intra-myocardial dissection.CONCLUSION: Intra-myocardial dissection should be considered as one of the rarest TS complications. Several studies are necessary for defining the exact pathophysiological mechanisms.

Keywords

Takotsubo Cardiomyopathy
Dissection
Cardiac Aneurysm
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ARYA Atherosclerosis Journal
Volume 15, Issue 1 - Serial Number 1
January and February 2019
Pages 33-37

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