Takotsubo Cardiomyopathy Triggered by Emotional Stress in an Elderly Female
Authors
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Marlon Carbonell González
Intensive Care Unit, Hospital Clínico Quirúrgico Miguel Enríquez, Havana, Cuba
https://orcid.org/0009-0008-5509-0409
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Maydelis Milo Alvarez
University of Medical Sciences of Pinar del Río, Faculty of Medical Sciences, Pinar del Río, Cuba
https://orcid.org/0009-0000-6229-5690
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Deborah Cabrera Rodríguez
University of Medical Sciences of Havana, "Miguel Enríquez" Faculty of Medical Sciences, Havana, Cuba.
https://orcid.org/0009-0002-1156-0225
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Mai Lyng Yon Wong
University of Medical Sciences of Havana, "Miguel Enríquez" Faculty of Medical Sciences, Havana, Cuba
https://orcid.org/0009-0002-9382-6743
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Lhianella Ramos Escobedo
Central University: Quito, Pihincha, Ecuador
https://orcid.org/0000-0003-2539-4731
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Eliany León Figueredo
University of Medical Sciences of Cienfuegos, Faculty of Medical Sciences, Cienfuegos, Cuba.
https://orcid.org/0009-0001-9063-4466
DOI:
https://doi.org/10.70099/BJ/2025.02.03.8Keywords:
Takotsubo cardiomyopathy, stress-induced cardiomyopathy, acute coronary syndrome, Wellens syndrome, apical thrombusAbstract
Takotsubo cardiomyopathy (TCM), also known as stress-induced cardiomyopathy or "broken heart syndrome," is a transient left ventricular systolic dysfunction typically precipitated by emotional or physical stress. It closely mimics acute coronary syndrome (ACS) but occurs in the absence of significant coronary artery obstruction. We present the case of a 73-year-old woman with a medical history of hypertension, diabetes mellitus, hyperlipidemia, and osteoporosis, who presented with sudden-onset chest pain radiating to the throat, left arm, shoulder, and neck, accompanied by nausea, vomiting, and diaphoresis. Initial evaluation revealed elevated high-sensitivity troponin and B-type natriuretic peptide (BNP) levels, along with electrocardiographic findings suggestive of Wellens syndrome. Emergent coronary angiography demonstrated only minimal atherosclerotic disease. Left ventriculography revealed apical akinesis with basal hyperkinesis, consistent with TCM; an apical thrombus was also identified. The patient was managed with anticoagulation and supportive medical therapy. This case underscores the importance of considering TCM in elderly female patients presenting with ACS-like symptoms, particularly when coronary angiography does not reveal significant obstructive lesions.
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