Does Recurrence Tend to Occur in a Previously Unaffected Ventricular Wall Region?
A 63-year-old woman has had 2 hospital admissions for central chest pain occurring in the setting of emotional stress over the last 11 years. Her other medical history included anxiety, hypertension, and dyslipidemia. At 52 years of age, she presented to the hospital with central chest pain after a major argument with her mother. An ECG demonstrated sinus rhythm with 1-mm ST-segment elevation in leads I and aVL. Her serum troponin I was mildly elevated at 0.63 μg/L (normal <0.03 μg/L). A coronary angiogram demonstrated no significant flow-limiting coronary artery lesions. A left ventriculogram demonstrated severe left ventricular dysfunction resulting from a large area of akinesis involving the anterior and apical wall segments. Subsequently, she developed pulmonary edema, which was treated with diuretic therapy. A transthoracic echocardiogram performed 4 days after admission demonstrated full recovery of the patient’s left ventricular dysfunction, consistent with a diagnosis of Takotsubo cardiomyopathy. She was treated with aspirin, a statin, and a calcium channel …