Takotsubo syndrome. Case report and literature review.

BACKGROUND: Takotsubo syndrome is a cardiopathy characterized by a dyskinesia or left ventricular apical ballooning and subsequent recovery of ventricular function. We undertook this study to present a case of Takotsubo syndrome.

CLINICAL CASE: We present the case of a 60-year-old female with a 26-year history of systemic arterial hypertension treated with 40 mg of termisartan daily. She started with headache after an emotional event (witness to an aggression of her son) associated with elevation of blood pressure that was suddenly accompanied by intense oppressive chest pain and neurovegetative symptoms. Electrocardiogram showed ST-segment elevation in anteroseptal and lateral derivations. Catheterization showed a 50% obstruction in the anterior descending artery and apical dyskinesia with hypercontractile base and 35% left ventricular ejection fraction. We performed stent angioplasty in the responsible artery. Nuclear medicine study showed extensive apical infarction, and echocardiogram agreed with transient apical dyskinesia and basal hypercontractility. After a 1-month evolution, echocardiogram mobility was completely recovered and myocardial perfusion study was normal 4 months later.

CONCLUSIONS: We show a transitory apical ballooning secondary to acute myocardial infarction associated with a significantly stressful event that resulted in complete improvement of ventricular function with percutaneous coronary intervention during the following 4 months.