Pseudo-apical hypertrophic cardiomyopathy phenotype in Takotsubo cardiomyopathy

TL;DR

This paper discusses how Takotsubo cardiomyopathy can mimic hypertrophic cardiomyopathy due to temporary heart wall thickening, highlighting the need for advanced imaging to distinguish between the two.

Contribution

The study highlights the diagnostic challenge of pseudo-apical hypertrophy in Takotsubo cardiomyopathy and advocates for serial cardiac MRI with tissue characterization.

Findings

Takotsubo cardiomyopathy can show transient apical wall thickening resembling hypertrophic cardiomyopathy.

The pseudo-hypertrophic appearance is caused by reversible myocardial edema, not true hypertrophy.

Serial cardiac MRI with tissue characterization is crucial for accurate diagnosis.

Abstract

Takotsubo cardiomyopathy can exhibit transient apical wall thickening during recovery, leading to a phenotypic overlap with apical hypertrophic cardiomyopathy. This pseudo-hypertrophic appearance is due to reversible myocardial oedema rather than genuine sarcomeric hypertrophy. We present a case demonstrating this diagnostic challenge and emphasising the importance of serial cardiac magnetic resonance imaging with tissue characterisation.

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