title: Acute biopsy-proven lymphocytic myocarditis mimicking Takotsubo cardiomyopathy.
abstract: Endomyocardial biopsy (EMB), the diagnostic gold standard for myocarditis, has not been systematically performed in the reported case series of Takotsubo cardiomyopathy, although proposed Mayo Criteria specify exclusion of myocarditis. Moreover, there is no specific recommendation for infarct-like acute myocarditis in the recently published guidelines on the role of EMB. Here we present a thoroughly documented case fulfilling both the proposed Mayo criteria for Takotsubo cardiomyopathy and the World Health Organization criteria for active, virus-negative, immune-mediated myocarditis. Since myocarditis can mimic acute myocardial infarction with normal coronary arteries, EMB should be performed to rule out myocarditis in patients presenting with LV apical ballooning syndrome (or Takotsubo cardiomyopathy).
authors.affiliation: Department of Cardiological, Thoracic and Vascular Sciences, University of Padova-Policlinico, Via Giustiniani, 2, 35128 Padova, Italy. alida.caforio@unipd.it
authors.forename: Alida L P
authors.initials: AL
authors.lastname: Caforio
authors.forename: Francesco
authors.initials: F
authors.lastname: Tona
authors.forename: Annalisa
authors.initials: A
authors.lastname: Vinci
authors.forename: Fiorella
authors.initials: F
authors.lastname: Calabrese
authors.forename: Angelo
authors.initials: A
authors.lastname: Ramondo
authors.forename: Luisa
authors.initials: L
authors.lastname: Cacciavillani
authors.forename: Francesco
authors.initials: F
authors.lastname: Corbetti
authors.forename: Loira
authors.initials: L
authors.lastname: Leoni
authors.forename: Gaetano
authors.initials: G
authors.lastname: Thiene
authors.forename: Sabino
authors.initials: S
authors.lastname: Iliceto
authors.forename: Annalisa
authors.initials: A
authors.lastname: Angelini
mesh_terms: D000208:Acute Disease; D000368:Aged; D001706:Biopsy / Q000379:methods*; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D009205:Myocarditis / Q000473:pathology* / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D013318:Stroke Volume / Q000502:physiology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis*