Case Report: Stepwise noninvasive diagnosis of Takotsubo cardiomyopathy in an elderly patient–From ECG clues to echocardiographic and CTA confirmation

Takotsubo cardiomyopathy (TTC) is frequently misdiagnosed as acute coronary syndrome in elderly patients. This case demonstrates how ECG findings facilitate a noninvasive diagnostic algorithm for TTC, validated by echocardiography and coronary computed tomography angiography (CCTA). An 88-year-old w...

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Published inFrontiers in cardiovascular medicine Vol. 12; p. 1608992
Main Authors Teng, Yanling, Sun, Xingxing, Wang, Minglang, Wang, Ziyang, Wang, Yilian
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 04.06.2025
Subjects
Cardiovascular Medicine
coronary CTA
ECG
elderly
noninvasive diagnosis
Takotsubo cardiomyopathy
ECG
coronary CTA
Takotsubo cardiomyopathy
noninvasive diagnosis
elderly
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Summary:Takotsubo cardiomyopathy (TTC) is frequently misdiagnosed as acute coronary syndrome in elderly patients. This case demonstrates how ECG findings facilitate a noninvasive diagnostic algorithm for TTC, validated by echocardiography and coronary computed tomography angiography (CCTA). An 88-year-old woman presented with chest tightness and dyspnea after emotional stress (bereavement). Initial ECGs showed the concurrent appearance of ST-segment elevations in anterior (V3-V5) and inferior leads (II, III, aVF), suggesting apical injury and the diagnosis of TTC. Bedside echocardiography revealed apical akinesis with preserved basal contraction (LVEF 35%), while CCTA ruled out obstructive disease. Supportive therapy led to symptom resolution. At 1-year follow-up, LVEF recovered to 61% with normalized ECG. This case highlights ECG's pivotal role in suspecting TTC, enabling a Noninvasive diagnostic approach (echocardiography + CCTA) for elderly patients.
Bibliography:ObjectType-Case Study-2
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Reviewed by: Mona Mostafa Rayan, Ain Shams University, Egypt
Edited by: Grigorios Korosoglou, GRN Klinik Weinheim, Germany
Lucia La Mura, Federico II University Hospital, Italy
These authors have contributed equally to this work
ORCID Xingxing Sun orcid.org/0000-0002-7283-0981
ISSN:2297-055X
2297-055X
DOI:10.3389/fcvm.2025.1608992