TAKOTSUBO SYNDROME – BROKEN HEART IN A 29-YEAR-OLD MALE PATIENT: CASE REPORT
Keywords:
Takotsubo syndrome; Stress cardiomyopathy; Young male; InterTAK; Cardiac magnetic resonance imagingAbstract
DOI: https://doi.org/10.46296/gt.v8i16.0294
Abstract
Introduction: Takotsubo syndrome (TTS), also known as stress cardiomyopathy, is an acute cardiomyopathy characterized by transient left ventricular dysfunction that mimics acute coronary syndrome, with elevated biomarkers and electrocardiographic changes, but without obstructive coronary lesions. Although it predominantly affects postmenopausal women, men can also be affected, and when this occurs, the course can be more torpid. Case presentation: A 29-year-old man with no relevant history presented with oppressive chest pain and sudden-onset dyspnea after intense physical and emotional stress. The electrocardiogram showed ST elevation in the anterolateral precordial leads and prolonged QTc; troponin was moderately elevated. Coronary angiography showed no significant stenosis. Ventriculography and echocardiogram revealed apical hypokinesia with an ejection fraction of 35%. Cardiac magnetic resonance imaging (CMRI) showed myocardial edema without late enhancement. An InterTAK score of 42 points was calculated. He was managed with supportive treatment (ACE inhibitor/ARB-II, beta-blocker, prophylactic anticoagulation) with favorable evolution and 100% recovery of ventricular function at 8 weeks. Conclusions: TTS should be considered in young men with symptoms consistent with acute coronary syndrome and normal coronary arteries. CMR and the application of the InterTAK score help to refine the differential diagnosis between myocarditis and MINOCA. Management is mainly supportive, with attention to complications such as cardiogenic shock, LV outflow tract obstruction, and apical thrombus.
Keywords: Takotsubo syndrome; Stress cardiomyopathy; Young male; InterTAK; Cardiac magnetic resonance imaging.
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