Introduction
Takotsubo Syndrome, commonly known as stress-induced cardiomyopathy, has been reported as an intriguing topic of discussion in many new studies (1). Japanese authors initially coined the name, which refers to the characteristic shape assumed by the left ventricle towards the end of systole, similar to octopus traps in Japan. A noticeably increasing trend has been noted in the cases presented in the past five years, reported from Europe, America, and Australia (2,3).
This pathology is estimated to account for 1-2% of all patients coming into clinical attention for acute ischemic events. Recent statistics reported by the American Heart Association show that out of the staggering 732,000 yearly dismissals with a primary diagnosis of acute MI, 7000-14000 may be attributable to stress-induced cardiomyopathy (4).
A literature search on PubMed revealed a significant number of cases demonstrating left ventricular ballooning at atypical sites, including the median ventricular level, the base of the ventricle, the inferior wall, or the anterior wall.
The Mayo Clinic has devised a diagnostic criterion comprising four key points, and fulfillment of all four conditions is required for an assertive diagnosis of this disease. The conditions are given below: (1,15)
1. Transitory decline in LV function that restores in time.
2. Exclusion of CAD and angiographic evidence against acute plaque rupture.
3. Newly developed ECG abnormalities and/or a significant elevation in cardiac enzymes.
4. Absence of any other pathology, such as pheochromocytoma or myocarditis.
In a first-of-its-kind report from the Middle East, we report a case of Takotsubo cardiomyopathy(TCM) with ventricular ballooning at the inferior wall in a patient who presented with chest pain and ECG findings suggestive of ischemia.