CASE REPORT
Broken heart as work-related accident: Occupational stress as a cause of takotsubo cardiomyopathy in 55-year-old female teacher – Role of automated function imaging
in diagnostic workflow
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1
Medical University of Lodz, Łódź, Poland (Chair and Department of Cardiology)
2
Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Environmental Epidemiology)
Int J Occup Med Environ Health. 2015;28(6):1031-4
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ABSTRACT
Takotsubo cardiomiopathy (TTC) (known also as “ampulla cardiomyopathy,” “apical ballooning” or “broken heart syndrome”)
is connected with a temporary systolic left ventricular dysfunction without the culprit coronary lesion. Takotsubo
cardiomyopathy was first described in 1990 in Japan after octopus trapping pot with a round bottom and narrow neck
similar in shape to left ventriculogram in TTC patients. The occurrence of TTC is usually precipitated by a stressful event
with a clinical presentation mimicking myocardial infarction: chest pain, ST-T segment elevation or T-wave inversion, a rise
in cardiac troponin, and contractility abnormalities in echocardiography. A left ventricular dysfunction is transient and
improves within a few weeks. Takotsubo cardiomyopathy typically occurs in postmenopausal women and the postulated
mechanism is catecholamine overstimulation. Moreover, the distribution of contractility impairments usually does not correspond
with typical region supplied by a single coronary artery. Therefore, the assessment of regional pattern of systolic
dysfunction with speckle-tracking echocardiography and automated function imaging (AFI) technique may be important in
diagnosis of TTC and may improve our insight into its patophysiology. We described a 55-year-old female teacher with TTC
diagnosed after acute psychological stress in workplace. The provoking factor related with occupational stress and pattern
of contraction abnormalities documented with AFI technique including basal segments of left ventricle make this case
atypical.