Tako-Tsubo cardiomyopathy atypical presentation

Abstract

Context: Takotsubo cardiomyopathy (TCM) affects mainly female patients following a stressful physical or psychological event; associated with a precordial pain clinic; with electrocardiographic changes, transient alterations of contractility of anteroapical predominance of the left ventricle (LV); with slightly increased markers of myocardial damage and no angiographic evidence of acute coronary vessel occlusion, as a triggering mechanism for the condition. Objective: To present the clinical case of a 73-year-old female patient with a choleric personality, who entered the emergency room with severe dyspnea and generalized cyanosis. Methodology: The Echocardiogram and Chest X-ray show a left Ventricle (LV) apical bulging. STK is an uncommon entity of a still unknown etiology, so the Mayo Clinic Diagnostic Criteria have been implemented for its diagnosis. Its treatment is empirical and multidisciplinary. Results: STK can be found in a clinical presentation of Acute Heart Failure, as the patient presented acute pulmonary edema and cardiogenic shock. It is appropriate to mention that due to the patient’s choleric nature, this is a diagnostic criterion and predisposing factor for presenting this disease. Conclusions: In the absence of clear therapeutic recommendations, the use of beta-blockers has been implemented, to counteract the deleterious effect of catecholamines, and to improve the flow in those patients presenting the Left Ventricular outflow tract obstruction (LVOTO).