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Case Reports in Cardiology
Volume 2019, Article ID 1010243, 6 pages
https://doi.org/10.1155/2019/1010243
Case Report

Takotsubo Syndrome Associated with ST Elevation Myocardial Infarction

1John Hunter Hospital, Hunter New England Health, Newcastle, NSW, Australia
2The University of Newcastle, Newcastle, NSW, Australia
3Hunter Medical Research Institute, Newcastle, NSW, Australia

Correspondence should be addressed to Andrew J. Boyle; ua.ude.eltsacwen@elyob.werdna

Received 2 December 2018; Revised 3 February 2019; Accepted 26 February 2019; Published 16 May 2019

Academic Editor: Man-Hong Jim

Copyright © 2019 Saad Ezad et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Takotsubo syndrome is a reversible heart failure syndrome which often presents with symptoms and ECG changes that mimic an acute myocardial infarction. Obstructive coronary artery disease has traditionally been seen as exclusion criteria for the diagnosis of takotsubo; however, recent reports have called this into question and suggest that the two conditions may coexist. Case Summary. We describe a case of an 83-year-old male presenting with chest pain consistent with acute myocardial infarction. The ECG demonstrated anterior ST elevation with bedside echocardiography showing apical wall motion abnormalities. Cardiac catheterisation found an occluded OM2 branch of the left circumflex artery with ventriculography confirming apical ballooning consistent with takotsubo and not in the vascular territory supplied by the occluded epicardial vessel. Repeat echocardiogram 6 weeks later confirmed resolution of the apical wall motion abnormalities consistent with a diagnosis of takotsubo. Discussion. This case demonstrates the finding of takotsubo syndrome in a male patient with acute myocardial infarction. Traditionally, this would preclude a diagnosis of takotsubo; however, following previous reports of takotsubo in association with coronary artery dissection and acute myocardial infarction in female patients, new diagnostic criteria have been proposed which allow the diagnosis of takotsubo in the presence of obstructive coronary artery disease. This case adds to the growing body of literature that suggests takotsubo can coexist with acute myocardial infarction; however, it remains to be elucidated if it is a consequence or cause of myocardial infarction.