Takotsubo cardiomyopathy with secondary coronary embolus.
We describe the case of a 65-year-old patient who was admitted to our tertiary centre with cardiac sounding chest pain and inferior ST elevation. Coronary angiography revealed mild plaque disease in the left anterior descending artery. The right coronary artery was smooth with no plaques with the exception of an occluded distal branch with no flow. The left ventriculogram revealed a ballooned and akinetic apex typical of Takotsubo syndrome (TS). We suspected a coronary embolus secondary to TS. A serial rise and fall in biomarkers of myocardial necrosis was noted. The patient was treated for acute coronary syndrome and discharged home 72 h from admission. Distal thromboembolism has been described in the literature before. On a search of PubMed there are no examples of coronary artery embolus in the context of TS.
Department of Medicine, Leighton Hospital, Crewe, UK.
Thomas David
TD
Heseltine
Vellore J
VJ
Karthikeyan
John
J
Morris
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D000368:Aged; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D004562:Electrocardiography; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D015635:Radionuclide Ventriculography; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000000981:diagnostic imaging