Abstract Background Takotsubo cardiomyopathy is a transient left ventricular dysfunction with an established recurrence rate in populations, however, recurrences in the same individual have not been well described. Case summary We present a 76-year-old woman who had likely a total of six recurrent takotsubo cardiomyopathy episodes spanning over 33 years. Her diagnosis of takotsubo cardiomyopathy was first made in 2014 when she presented with chest pain, raised cardiac enzymes, and the presence of normal coronary arteries. Cardiac magnetic resonance was performed, ruling out any current or previous myocardial infarction. Subsequently, she had two further recurrences in 2015 and 2018. Stressors were identified on three occasions. She was diagnosed with ‘myocardial infarction’ in 1986, 1988, and 1998 when she presented with chest pain and electrocardiogram changes, despite demonstrating normal coronary arteries on each occasion. Discussion This case demonstrates three confirmed recurrent episodes of takotsubo in the same individual, showing three different left ventricular phenotypic morphologies on the background of three previous episodes of ‘myocardial infarction with normal coronary arteries’, which most likely might have been takotsubo episodes as well. Any myocardial infarction-type injury was definitely ruled out in the 2014 admission instigating a potential change in this patient’s past medical history and implicitly requirement for lifelong secondary prevention. It is notably difficult to make a confirmed diagnosis of takotsubo cardiomyopathy back in 1986, 1988, and 1998 due to the lack of awareness in this novel topic.
[1]
Jeroen J. Bax,et al.
A novel clinical score (InterTAK Diagnostic Score) to differentiate takotsubo syndrome from acute coronary syndrome: results from the International Takotsubo Registry
,
2017,
European journal of heart failure.
[2]
M. Borggrefe,et al.
Clinical and echocardiographic analysis of patients suffering from recurrent takotsubo cardiomyopathy
,
2016,
Journal of geriatric cardiology : JGC.
[3]
J. Horowitz,et al.
Systematic review and meta-analysis of incidence and correlates of recurrence of takotsubo cardiomyopathy.
,
2014,
International journal of cardiology.
[4]
Barry J Maron,et al.
Natural history and expansive clinical profile of stress (tako-tsubo) cardiomyopathy.
,
2010,
Journal of the American College of Cardiology.
[5]
A. Lerman,et al.
Four-year recurrence rate and prognosis of the apical ballooning syndrome.
,
2007,
Journal of the American College of Cardiology.
[6]
H. Satoh.
Takotsubo-type cardiomyopathy due to multivessel spasm
,
1990
.