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.