PT  - JOURNAL ARTICLE
AU  - Vivekanantham, Hari
AU  - Scoglio, Martin
AU  - Suter, Philipp
AU  - Cook, Stephane
AU  - Roux, Yann
AU  - Arroyo, Diego
TI  - Elderly woman presenting with multivessel coronary artery disease and Takotsubo syndrome
AID  - 10.1136/bcr-2021-242367
DP  - 2021 Jul 01
TA  - BMJ Case Reports
PG  - e242367
VI  - 14
IP  - 7
4099  - http://casereports.bmj.com/content/14/7/e242367.short
4100  - http://casereports.bmj.com/content/14/7/e242367.full
SO  - BMJ Case Reports2021 Jul 01; 14
AB  - Takotsubo syndrome is an acute and often reversible condition, with initial presentation mimicking acute coronary syndrome. Typically, patients present with left ventricular regional wall motion abnormalities, without a corresponding coronary artery obstruction on angiography. Coexistence of a coronary artery disease is possible and may render the distinction between the two entities particularly challenging. We report the case of a 94-year-old woman with chest pain after an emotional upset and acute myocardial injury. Transthoracic echocardiogram (TTE) revealed a severely reduced left ventricular ejection fraction (LVEF) with apical ballooning. Coronary angiogram showed significant stenosis of the distal left main coronary artery and of the mid-left anterior descending artery, as well as a 30%–50% stenosis of the mid-distal right coronary artery. Revascularisation was deferred and antiplatelet as well as heart failure therapy begun. A repeat TTE 6 days later revealed a quasi-normalised LVEF. Ultimately, percutaneous coronary revascularisation of the left main and left anterior descending artery was performed, with favourable outcome at 6-month follow-up.