JACC. Case reports · 2026
Apical-to-Mid-Ventricular Phenotypic Shift in Recurrent Takotsubo Syndrome After Minor Trauma.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Khoury Fady, Chandi Manpaul, Johal Manraj, Pourafkari Leili, Kar Saibal
Аннотация
BACKGROUND: Takotsubo syndrome (TTS) typically presents as classic apical ballooning, but recurrent episodes may manifest a distinct phenotype. Physical trauma is an underappreciated potential trigger for atypical phenotypes.
CASE SUMMARY: An 84-year-old woman with prior apical TTS sustained a ground-level fall with blunt chest trauma. Troponin I rose from 1,266 to 5,458 ng/L with new lateral T-wave inversions (aVL). Echocardiography showed mid-ventricular akinesia with a hyperkinetic apex (left ventricular ejection fraction ∼35%). Coronary angiography excluded obstructive disease; left ventriculography confirmed mid-ventricular variant TTS, and cardiac magnetic resonance showed myocardial edema without late gadolinium enhancement. Recurrence developed despite long-term beta-blocker and angiotensin-converting enzyme inhibitor therapy; left ventricular function recovered fully within 4 weeks.
DISCUSSION: This case provides multimodality imaging documentation of an apical-to-mid-ventricular phenotypic switch in recurrent TTS precipitated by minor trauma.
TAKE-HOME MESSAGE: Maintain high suspicion for recurrent TTS with altered phenotype after falls; serial multimodality imaging is essential; pharmacotherapy does not reliably prevent recurrence, so nonpharmacologic risk reduction is important.
CASE SUMMARY: An 84-year-old woman with prior apical TTS sustained a ground-level fall with blunt chest trauma. Troponin I rose from 1,266 to 5,458 ng/L with new lateral T-wave inversions (aVL). Echocardiography showed mid-ventricular akinesia with a hyperkinetic apex (left ventricular ejection fraction ∼35%). Coronary angiography excluded obstructive disease; left ventriculography confirmed mid-ventricular variant TTS, and cardiac magnetic resonance showed myocardial edema without late gadolinium enhancement. Recurrence developed despite long-term beta-blocker and angiotensin-converting enzyme inhibitor therapy; left ventricular function recovered fully within 4 weeks.
DISCUSSION: This case provides multimodality imaging documentation of an apical-to-mid-ventricular phenotypic switch in recurrent TTS precipitated by minor trauma.
TAKE-HOME MESSAGE: Maintain high suspicion for recurrent TTS with altered phenotype after falls; serial multimodality imaging is essential; pharmacotherapy does not reliably prevent recurrence, so nonpharmacologic risk reduction is important.