Tako-tsubo syndrome – a broken heart is not just a metaphor

Overview

Glaba L, Trinh MD, Toušek P. Tako-tsubo syndrome – a broken heart is not just a metaphor

In this article, we describe the case of a 65-year-old female patient with a history of arterial hypertension who was hospitalized at the Cardiology Clinic of the University Hospital of Královské Vinohrady with apical form of Tako-Tsubo syndrome (TTS) with a relatively typical clinical picture and course of this disease. Initially, the patient presented to the emergency internal admission of the University Hospital of Královské Vinohrady due to low blood pressure, weakness and precolapse, where acute myocardial infarction without ST elevation (NSTEMI) was suspected due to troponin elevation and ECG changes. With this working diagnosis, the patient was subsequently admitted to the coronary unit. After admission to the bed, transthoracic echocardiography (TTE) was completed with the finding of mild systolic dysfunction of the left ventricle (LV) with an ejection fraction (EF) of 40–45%, akinesia of the apex and adjacent apical segments of all walls. Subsequently, selective coronary angiography was completed with the finding of a normal coronary angiogram and subsequent ventriculography confirmed a kinetic disorder corresponding to the apical form of TTS. The further course of hospitalization was without complications and the patient was discharged to outpatient care in good condition. At outpatient check-up after 1 month, almost complete normalization of LV function was demonstrated. Our case report therefore presents a typical case of TTS, an interesting clinical entity, which, with better availability of diagnostic examinations and better awareness of this disease, is already a relatively well-known diagnosis in the Czech Republic.

Keywords:

acute coronary syndrome – chest pain – Tako-tsubo syndrome