Isolated Right Ventricular Takotsubo Cardiomyopathy: Beyond the Left Ventricle.

BACKGROUND

Isolated right ventricular (RV) Takotsubo cardiomyopathy is a rare stress-induced variant characterized by acute RV failure with preserved left ventricular function.

CASE SUMMARY: A 43-year-old woman with prior gastric bypass surgery presented with abdominal pain, hypotension, chest tightness, and dyspnea. Echocardiography demonstrated severe RV free wall hypokinesis with preserved apical contraction, moderate RV enlargement, and normal left ventricular function. Pulmonary embolism, obstructive coronary disease, and secondary causes of RV failure were excluded by computed tomography, coronary angiography, and right heart catheterization. Supportive management resulted in complete recovery of RV function.

DISCUSSION: This case illustrates the challenge of evaluating isolated acute RV failure. Multimodal imaging was essential to distinguish primary RV myocardial stunning from other etiologies of RV dysfunction.

TAKE-HOME MESSAGE: RV Takotsubo cardiomyopathy should be considered when assessing a patient with isolated acute RV failure and is a diagnosis of exclusion.