title: Surgical treatment of left ventricular wall rupture, regarded as a consequence of Takotsubo cardiomyopathy.
abstract: OBJECTIVE
  We present the case of possible reverse type of TCM in a female patient presented with progressive left ventricular dysfunction and its rupture in pericardium.
  
  
  METHODS
  The detailed history, physical examination, laboratory tests, electrocardiography, serial echocardiography, coronary angiography with left ventriculography were performed to diagnose possible Takotsubo cardiomyopathy in 63-year old woman admitted to our center with complaints of dyspnea, lightheadedness, weakness and signs of hypotension and history of inferior myocardial infarction, acute left ventricular aneurysm, and effusive pericarditis and pleuritis, developed after emotional stress 5 months ago.
  
  
  RESULTS
  Clinical evaluation revealed unremarkable laboratory tests, normal troponin values, signs of old inferior myocardial infarction on electrocardiogram, and left ventricular (LV) dilatation and dysfunction, akinesia of LV infero-lateral wall with thinning and its rupture and blood shunting in pericardium. Her coronary angiography revealed normal coronary arteries. The diagnosis of pheochromocytoma was excluded. The patient underwent surgery under cardiopulmonary bypass with removal of LV pseudoaneurysm. The patient was discharged from hospital with improvement in NYHA class and LV function.
  
  
  CONCLUSIONS
  Thus, in female postmenopausal patients presenting with acute myocardial infarction signs complicated by pericarditis, intact coronary arteries and LV dysfunction with emotional stress as triggering factor, reverse type of TCM should be considered and proper management applied to prevent development of life-threatening complications like LV rupture.
authors.affiliation: Scientific Research Institute of Heart Surgery and Organ Transplantation, Bishkek, Kyrgyzstan.
authors.forename: Taalaibek
authors.initials: T
authors.lastname: Kudaiberdiev
authors.affiliation: Scientific Research Institute of Heart Surgery and Organ Transplantation, Bishkek, Kyrgyzstan.
authors.forename: Irina
authors.initials: I
authors.lastname: Akhmedova
authors.affiliation: Scientific Research Institute of Heart Surgery and Organ Transplantation, Bishkek, Kyrgyzstan.
authors.forename: Gulzada
authors.initials: G
authors.lastname: Imanalieva
authors.affiliation: Scientific Research Institute of Heart Surgery and Organ Transplantation, Bishkek, Kyrgyzstan.
authors.forename: Ildar
authors.initials: I
authors.lastname: Abdildaev
authors.affiliation: Scientific Research Institute of Heart Surgery and Organ Transplantation, Bishkek, Kyrgyzstan.
authors.forename: Kilichbek
authors.initials: K
authors.lastname: Jooshev
authors.affiliation: Scientific Research Institute of Heart Surgery and Organ Transplantation, Bishkek, Kyrgyzstan.
authors.forename: Jamalbek
authors.initials: J
authors.lastname: Ashimov
authors.affiliation: Scientific Research Institute of Heart Surgery and Organ Transplantation, Bishkek, Kyrgyzstan.
authors.forename: Azamat
authors.initials: A
authors.lastname: Mirzabekov
authors.affiliation: Scientific Research Institute of Heart Surgery and Organ Transplantation, Bishkek, Kyrgyzstan.
authors.forename: Janibek
authors.initials: J
authors.lastname: Gaybildaev
keywords: Takotsubo cardiomyopathy; pericardium; reverse type; ventricular wall rupture