Takotsubo-cardiomyopathy: A case of extremely fast recovery described by multimodality cardiac imaging

A 67-year-old male was admitted on the suspicionof STEMI due to chest pain after strenuous work, lateralST-elevation on ECG and troponin T 523 ng/L (ref.\50 ng/L). He had hypertension, hypercholesterolaemiaand was an ex-smoker but was otherwise healthy. Acutecoronary angiography showed no culprit lesion butapical ballooning on ventriculography (Figure 1A).Several image modalities were performed as part of aresearch protocol:Cardiac SPECT during resting conditions 15 hours afteradmission (Figure 1B) showed a relative perfusionreductionoftheapexandmidventricularpart,extent40%.Cardiac MRI 22 h after admission (Figure 1C) showedapical ballooning and LVEF 40% (ref. 56%-78%) andbasal hypercontractility, but no sign of infarction.Echocardiography 35 h after admission (Figure 1D)showed an akinetic apex and LVEF 50%.A second cardiac MRI 48 hours after admission(Fig. 1E) showed normalized LVEF 70%, but persis-tent apical hypokinesia and edema.N