Published online Oct 26, 2018. doi: 10.4330/wjc.v10.i10.187
Peer-review started: June 5, 2018
First decision: June 14, 2018
Revised: July 25, 2018
Accepted: July 22, 2018
Article in press: August 31, 2018
Published online: October 26, 2018
We report three cases of Takotsubo syndrome (TS) with atypical myocardial involvement. All three cases were triggered by physical or mental stress, resulting in transient myocardial compromise. However, the clinical presentation, localization and extent of myocardial damage varied in each case, ranging from low-risk acute chest pain to cardiogenic shock with low ejection fraction and dynamic obstruction of the left ventricular outflow tract. These cases outline the range of possible presentations of this rare entity and illustrate atypical forms of TS.
Core tip: Although less frequent, atypical presentations of Takotsubo syndrome - different from the classical apical ballooning - need prompt recognition by physicians. In addition to being a diagnostic challenge, this malady can present with severe complications, such as cardiogenic shock, arrhythmias and others. Herein, we show the presentation and management of atypical cases, with emphasis on their clinical recognition.