An Unusual Mid‐Ventricular Takotsubo Cardiomyopathy: A Case Report

TL;DR

A rare case of mid-ventricular takotsubo cardiomyopathy is reported, highlighting the importance of advanced imaging for accurate diagnosis.

Contribution

The case presents a rare mid-ventricular variant of TTC confirmed through multimodal imaging.

Findings

Mid-ventricular hypokinesis was identified via CMR without apical or basal involvement.

The patient fully recovered with normalized cardiac function on follow-up.

Echocardiography and CMR proved critical in diagnosing atypical TTC.

Abstract

Takotsubo cardiomyopathy (TTC), also known as stress cardiomyopathy, is characterized by transient regional wall motion abnormalities that mimic acute coronary syndrome (ACS) but without obstructive coronary artery disease. Among its various forms, the mid‐ventricular variant is uncommon and diagnostically challenging. We present a case of a 77‐year‐old female patient with chest discomfort, elevated troponin, and ECG changes mimicking ACS. Coronary angiography revealed unobstructed coronary arteries. Multimodal imaging, particularly cardiac magnetic resonance (CMR), demonstrated circumferential mid‐ventricular hypokinesis, sparing the apical and basal segments, which confirmed mid‐ventricular transmural thickening (TTC). The patient experienced full clinical recovery with normalization of cardiac function on follow‐up imaging. This case underscores the diagnostic value of echocardiography and CMR in distinguishing atypical TTC from other myocardial pathologies.

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