title: Myocardial cleft in a patient with Takotsubo cardiomyopathy: an unusual association identified by cardiac magnetic resonance.
abstract: We present the case of an 84-year-old woman admitted for Takotsubo cardiomyopathy complicated by congestive heart failure. Cardiovascular magnetic resonance (CMR) imaging was performed on day five and confirmed severely depressed left ventricular systolic function with typical apical ballooning. In steady-state free precession long-axis cine imaging, a basal inferior myocardial cleft was also observed, with no signs of myocardial noncompaction or regional wall motion abnormalities involving this segment. The pre-discharge CMR study confirmed the presence of a basal inferior myocardial cleft and significant improvement in left ventricular systolic function. Myocardial clefts are congenital abnormalities that have been described in healthy individuals as well as in the setting of hypertrophic cardiomyopathy, but it is not clear whether it is a benign structural variant or a distinct cardiomyopathy phenotype. To our knowledge this is the first reported case of this abnormality in a patient with Takotsubo cardiomyopathy.
authors: Cardiology Department, São João Hospital, Oporto Faculty of Medicine, Porto, Portugal. Electronic address: ribeiro_vania@hotmail.com.
authors: Vânia
authors: V
authors: Ribeiro
authors: Cardiology Department, São João Hospital, Oporto Faculty of Medicine, Porto, Portugal.
authors: Teresa
authors: T
authors: Pinho
authors: Cardiology Department, São João Hospital, Oporto Faculty of Medicine, Porto, Portugal.
authors: Sílvia Marta
authors: SM
authors: Oliveira
authors: Radiology Department, São João Hospital, Oporto Faculty of Medicine, Porto, Portugal.
authors: António J
authors: AJ
authors: Madureira
authors: Radiology Department, São João Hospital, Oporto Faculty of Medicine, Porto, Portugal.
authors: Isabel
authors: I
authors: Ramos
authors: Cardiology Department, São João Hospital, Oporto Faculty of Medicine, Porto, Portugal.
authors: Maria Júlia
authors: MJ
authors: Maciel
mesh_terms: D000369:Aged, 80 and over; D057791:Cardiac Imaging Techniques; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D054549:Takotsubo Cardiomyopathy / Q000150:complications*
keywords: Cardiovascular magnetic resonance; Myocardial cleft; Takotsubo cardiomyopathy