Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Oct 26, 2018; 10(10): 187-190
Published online Oct 26, 2018. doi: 10.4330/wjc.v10.i10.187
Takotsubo syndrome - different presentations for a single disease: A case report and review of literature
Alberto Fuensalida, Maurice Cortés, Luigi Gabrielli, Manuel Méndez, Alejandro Martínez, Gonzalo Martínez
Alberto Fuensalida, Maurice Cortés, Luigi Gabrielli, Manuel Méndez, Alejandro Martínez, Gonzalo Martínez, Division of Cardiovascular Diseases, Pontificia Universidad Católica de Chile, Santiago 833024, Metropolitana, Chile
Author contributions: Fuensalida A and Martinez G designed the report; Fuensalida A and Cortes M collected the clinical data; Gabrielli L performed the echocardiographies; Martinez A, Mendez M and G Martinez reviewed the coronary angiographies; Fuensalida A, Cortes M and Martinez G wrote the paper; Gabrielli L, Martinez A and Mendez M revised and commented the final manuscript.
Supported by a CONICYT research Grant (FONDECYT Iniciació n 11170205) for Dr Gonzalo Martí nez
Informed consent statement: All patients agreed to treatment and data collection by written consent at our institution.
Conflict-of-interest statement: The authors do not have any conflict of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gonzalo Martínez, MD, MPhil, Assistant Professor, Division of Cardiovascular Diseases, Pontificia Universidad Católica de Chile, Marcoleta 367, 2nd floor, Santiago 833024, Metropolitana, Chile. gmartinezr@med.puc.cl
Telephone: +56-223-543114
Received: June 5, 2018
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
Abstract

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.

Keywords: Coronary angiography, Acute coronary syndrome, Stress cardiomyopathy, Takotsubo syndrome

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.