Variant Type of Stress Cardiomyopathy: Inverted Takotsubo Syndrome

Introduction

Takotsubo syndrome (TTS), also known as stress cardiomyopathy, is a rare condition characterized by transient systolic and diastolic LV dysfunction, with akinesia of the apex and compensatory basal hyperkinesia, giving the heart the aspect of “apical ballooning”, described for the first time in 1990 in Japan. Its clinical presentation mainly includes chest pain, which often has typical angina characteristics, and dyspnea, being an important differential diagnosis from a classic acute coronary syndrome (ACS).

TTS is observed predominantly among postmenopausal women, and the emotional stress is considered a precipitating factor in most studies. Its etiology is still controversial, and the excess of circulating catecholamine is the most acceptable mechanism.^–

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