An-Najah Staff

Tako-tsubo cardiomyopathy (TCM) is an acute cardiac syndromeofunknownetiologycharacterizedbyseverebuttransient systolic dysfunction of the apical and/or mid segments of the LV mimicking myocardial infarction in the absence of obstructive coronary artery disease [1, 2]. This form of contractile dysfunction is typically transient and reversible within days or weeks [3, 4]. Symptoms are similar to those of acute MI, including sudden onset of chest pain associatedwithconvexST-segmentelevationandamoderate increaseincreatinekinaseandtroponinlevels[5].Symptoms commonly occur after emotional or physical stress [3, 5, 6], predominantlyinpostmenopausalwomen(90%ofcases)[3, 7, 8]. An association with malignancies has been reported in approximately 50 patients, potentially as a result of paraneoplastic phenomena [9, 10]. Several studies showed that left ventricular outflow tract obstruction (LVOTO) might be present in up to 25% of patients with TCM. It remains unclear if LVOTO is the cause or result of TCM. There are a few case reports in the literature reporting an association between TCM and hypertrophic
obstructive cardiomyopathy (HOCM). In these patients, there was a pressure gradient below the level of the aortic valve between the aorta and the left ventricle.