title: Apical ballooning with mid-ventricular obstruction: the many faces of Takotsubo cardiomyopathy.
abstract: Takotsubo cardiomyopathy (TTC) is a transient left ventricular dysfunction due to akinesia of the left-ventricular (LV) mid-apical segments (apical ballooning), which can cause severe reduction in LV systolic function. The typical clinical picture of TTC include chest pain, electrocardiographic changes consisting of mild ST-segment elevation followed by diffuse deep T-wave inversion, QTc interval prolongation and mild troponin release in the absence of significant coronary stenoses. The syndrome often affects post-menopausal women and is triggered by sympathetic overstimulation, like intense physical or emotional stress, so that it is called the "broken heart syndrome". Although left-ventricular systolic dysfunction usually fully recovers within few days, heart failure can still complicate the early phase. We report a case of stress-induced cardiomyopathy that had full recovery after 4 weeks of follow up. The main electrocardiographic, angiographic and imaging features are discussed.
authors.affiliation: Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Spadotto
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elmaghawry
authors.affiliation: Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Zorzi
authors.affiliation: Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Migliore
authors.affiliation: Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
authors.forename: Martina Perazzolo
authors.initials: MP
authors.lastname: Marra
keywords: T-waves; Takotsubo; cardiomyopathy; electrocardiogram; myocardial edema; stress-induced