RT Journal Article
SR Electronic
T1 Elderly woman presenting with multivessel coronary artery disease and Takotsubo syndrome
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e242367
DO 10.1136/bcr-2021-242367
VO 14
IS 7
A1 Vivekanantham, Hari
A1 Scoglio, Martin
A1 Suter, Philipp
A1 Cook, Stephane
A1 Roux, Yann
A1 Arroyo, Diego
YR 2021
UL http://casereports.bmj.com/content/14/7/e242367.abstract
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.