title: Takotsubo cardiomyopathy associated with rupture of the left ventricular apex: assessment of histopathological features of a fatal case and literature review.
abstract: Takotsubo cardiomyopathy, also known as "broken heart syndrome," is a cardiac entity characterized by transient left ventricular dysfunction without obstructive atherosclerotic coronary artery disease. An episode of emotional stress is believed to act as a trigger in the development of this syndrome, which typically occurs in female patients. We report a fatal case of a previously healthy 70-year-old woman who suffered an out-of-hospital cardiac arrest and cardiac rupture during emotional distress, due to Takotsubo cardiomyopathy. Ventricular rupture with Takotsubo cardiomyopathy is rare, but our case emphasizes the importance of dealing with this serious and potentially life-threatening disease. Takotsubo cardiomyopathy should be considered as a differential diagnosis in cases of early-developing heart failure, and clinicians should subsequently use adequate diagnostic and therapeutic options.
authors.affiliation: Department "GF Ingrassia", Section of Legal Medicine, University of Catania, Via S. Sofia, 87 - Edificio C, 95123, Catania, Italy. fra.indorato@gmail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Indorato
authors.affiliation: Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: Yoshihiro J
authors.initials: YJ
authors.lastname: Akashi
authors.affiliation: Diagnostic Pathology, Garibaldi Nesima Hospital, Catania, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Rossitto
authors.affiliation: Diagnostic Pathology, Garibaldi Nesima Hospital, Catania, Italy.
authors.forename: Cataldo
authors.initials: C
authors.lastname: Raffino
authors.affiliation: Department "GF Ingrassia", Section of Legal Medicine, University of Catania, Via S. Sofia, 87 - Edificio C, 95123, Catania, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bartoloni
mesh_terms: D000368:Aged; D017809:Fatal Outcome; D005260:Female; D006341:Heart Rupture / Q000209:etiology / Q000473:pathology*; D006352:Heart Ventricles / Q000293:injuries* / Q000473:pathology*; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology; D010490:Pericardial Effusion / Q000209:etiology / Q000473:pathology; D013315:Stress, Psychological / Q000150:complications; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000209:etiology
keywords: Emotional stress; Stress cardiomyopathy; Takotsubo cardiomyopathy; Ventricular rupture