Takotsubo cardiomyopathy in a 78-year-old woman: case report
DOI: 10.32364/2587-6821-2025-9-1-11
A.M. Alieva1, E.V. Reznik1, E.A. Khachirova1, V.I. Svetlakov2, N.V. Teplova1, E.A. Butorova2, D.V. Pevzner2, A.S. Tereshchenko2, K.V. Voronkova1, A.M. Rakhaev3, A.O. Asanov3, A.M. Abishev2, A.B. Sultangalieva1, A.A. Musukaev1, I.G. Nikitin1
1Pirogov Russian National Research Medical University, Moscow, Russian Federation
2Acad. E.I. Chazov National Medical Research Center of Cardiology, Moscow, Russian Federation
3H.M. Berbekov Kabardian-Balkar State University, Nalchik, Russian Federation
Тakotsubo cardiomyopathy is characterized by transient cardiac contractility disorders, mainly in the left ventricle, that occur under stress and other adverse conditions. The clinical picture resembles acute myocardial infarction with intact coronary arteries, and the cardiomyopathy resolves completely over time. The treatment is nonspecific. Along with this, prevention of thromboembolic complications, arrhythmia, and heart failure is of great importance. The clinical case of a 78-year-old patient hospitalized with complaints of burning precordialgia unrelated to physical exertion. Troponin T level increased to 3240 pg/ml (reference range: 0.1-15.6 pg/ml). No diagnostically significant abnormalities were detected during electrocardiography, cardiac ultrasound, and coronary angiography. Magnetic resonance imaging of the heart revealed a specific pattern of stress-induced cardiomyopathy. The patient was prescribed angiotensin-converting enzyme inhibitors, statins, beta-blockers, anticoagulants and antiplatelet agents. Due to the therapy, anginal pain did not recur; arrhythmia and heart failure were not detected. Recovered levels of myocardial damage markers were reported. Considering similar symptoms of takotsubo cardiomyopathy and acute coronary syndrome, more in-depth instrumental diagnosis should be performed in case of intact coronary arteries associated with lack of a typical electrocardiographic and echocardiographic picture. The clinical case observed by the authors clearly demonstrates that timely therapy contributes to a favorable outcome of the disease.
Keywords: cardiomyopathy, takotsubo, stress-induced cardiomyopathy, left ventricle, echocardiography, magnetic resonance imaging.
For citation: Alieva A.M., Reznik E.V., Khachirova E.A., Svetlakov V.I., Teplova N.V., Butorova E.A., Pevzner D.V., Tereshchenko A.S., Voronkova K.V., Rakhaev A.M., Asanov A.O., Abishev A.M., Sultangalieva A.B., Musukaev A.A., Nikitin I.G. Takotsubo cardiomyopathy in a 78-year-old woman: case report. Russian Medical Inquiry. 2025;9(1):85–92 (in Russ.). DOI: 10.32364/2587-6821-2025-9-1-11
About the authors:
Amina M. Alieva — C. Sc. (Med.), Assistant Professor of the Academician G.I. Storozhakov Department of Hospital Therapy, Institute of Clinical Medicine, Pirogov Russian National Research Medical University; 1, build. 6, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0000-0001-5416-8579
Elena V. Reznik — Dr. Sc. (Med.), Assistant Professor, Head of the Department of Propaedeutics of Internal Diseases No. 2, Institute of Clinical Medicine, Pirogov Russian National Research Medical University; 1, build. 6, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0000-0001-7479-418X
Elvira A. Khachirova — C. Sc. (Med.), Assistant Professor of the Department of Propaedeutics of Internal Diseases No. 2, Institute of Clinical Medicine, Pirogov Russian National Research Medical University; 1, build. 6, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0000-0003-2523-8907
Vyacheslav I. Svetlakov — Teaching Assistant of the Academician G.I. Storozhakov Department of Hospital Therapy, Institute of Clinical Medicine, Pirogov Russian National
Research Medical University; 1, build. 6, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0000-0001-8654-4030
Natalia V. Teplova — Dr. Sc. (Med.), Professor, Head of the Department of Clinical Pharmacology, Institute of Clinical Medicine, Pirogov Russian National Research Medical University; 1, build. 6, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0000-0002-7181-4680
Ekaterina A. Butorova — C. Sc. (Med.), Head of the Department of Radiodiagnosis, Acad. E.I. Chazov National Medical Research Center of Cardiology; 15A, Acad. Chazov str., Moscow, 121552, Russian Federation; ORCID iD 0000-0001-9706-7049
Dmitryi V. Pevzner — Dr. Sc. (Med.), Head of the Department of Emergency Cardiology, Acad. E.I. Chazov National Medical Research Center of Cardiology; 15A, Acad. Chazov str., Moscow, 121552, Russian Federation; ORCID iD 0000-0002-5290-0065
Andrey S. Tereshchenko — C. Sc. (Med.), Senior Scientific Officer of the Department of X-ray Endovascular Methods of Diagnosis and Treatment, Acad. E.I. Chazov National Medical Research Center of Cardiology; 15A, Acad. Chazov str., Moscow, 121552, Russian Federation; ORCID iD 0000-0002-4198-0522
Kira V. Voronkova — Dr. Sc. (Med.), Professor of the Department of Neurology, Institute of Continuing Education and Professional Development, Pirogov Russian National Research Medical University; 1, build. 6, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0000-0003-1111-6378
Alik M. Rakhaev — Dr. Sc. (Med.), Professor, Professor of the Department of Pediatric Diseases, Obstetrics and Gynecology, H.M. Berbekov Kabardian-Balkar State University, Nalchik, Russian Federation; 173, Chernyshevskiy str., Nalchik, 360004, Russian Federation; ORCID iD 0000-0001-9601-1174
Alim O. Asanov — C. Sc. (Med.), Assistant Professor of the Department of Neurology, Psychiatry and Narcology, H.M. Berbekov Kabardian-Balkar State University, Nalchik, Russian Federation; 173, Chernyshevskiy str., Nalchik, 360004, Russian Federation; ORCID iD 0009-0000-2507-4530
Artur M. Abishev — Cardiologist, Admission Department, Acad. E.I. Chazov National Medical Research Center of Cardiology; 15A, Acad. Chazov str., Moscow, 121552, Russian Federation; ORCID iD 0009-0003-7880-1617
Albina B. Sultangalieva — 6th-year Student of the Faculty of General Medicine, Pirogov Russian National Research Medical University; 1, build. 6, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0009-0008-4194-8486
Azret A. Musukaev — 5th-year Student of the Faculty of General Medicine, Pirogov Russian National Research Medical University; 1, build. 6, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0009-0003-7010-4470
Igor G. Nikitin — Dr. Sc. (Med.), Professor, Head of the Academician G.I. Storozhakov Department of Hospital Therapy, Institute of Clinical Medicine, Pirogov Russian National Research Medical University; 1, build. 6, Ostrovityanov str., Moscow, 117437, Russian Federation; ORCID iD 0000-0003-1699-0881
Contact information: Amina M. Alieva, e-mail: amisha_alieva@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 11.01.2025.
Revised 04.02.2025.
Accepted 27.02.2025.
2. Dote K., Sato H., Tateishi H. et al. Myocardial stunning due to simultaneous multivessel coronary spasms: a review of 5 cases. J Cardiol. 1991;21:203–214. PMID: 1841907
3. Болдуева С.А., Евдокимов Д.С. Кардиомиопатия такоцубо. Обзор данных литературы: понятие, эпидемиология, патогенез. Часть I. Российский кардиологический журнал. 2022;27(3S):4993. DOI: 10.15829/1560-4071-2022-4993Boldueva S.A., Evdokimov D.S. Takotsubo cardiomyopathy. Literature review: concept, epidemiology, pathogenesis. Part I. Russian Journal of Cardiology. 2022;27(3S):4993 (in Russ.). DOI: 10.15829/1560-4071-2022-4993
4. Amin H.Z., Amin L.Z., Pradipta A. Takotsubo Cardiomyopathy: A Brief Review. J Med Life. 2020;13(1):3–7. DOI: 10.25122/jml-2018-0067
5. Y-Hassan S., Tornvall P. Epidemiology, pathogenesis, and management of takotsubo syndrome. Clin Auton Res. 2018;28(1):53–65. DOI: 10.1007/s10286-017-0465-z
6. Falola A.O., Razvi N., Gada R. et al. Takotsubo Syndrome or Peripartum Cardiomyopathy? Depends on Who You Are Talking to. Behav Sci (Basel). 2024;14(9):777. DOI: 10.3390/bs14090777
7. Cau R., Masala S., Manelli L. et al. Cardiovascular Magnetic Resonance Imaging of Takotsubo Syndrome: Evolving Diagnostic and Prognostic Perspectives. Echocardiography. 2024;41(10):e15949. DOI: 10.1111/echo.15949
8. Singh T., Khan H., Gamble D.T. et al. Takotsubo Syndrome: Pathophysiology, Emerging Concepts, and Clinical Implications. Circulation. 2022;145(13):1002–1019. DOI: 10.1161/CIRCULATIONAHA.121.055854
9. Ahmed T., Lodhi S.H., Haigh P.J. et al. The many faces of takotsubo syndrome: A review. Curr Probl Cardiol. 2024;49(3):102421. DOI: 10.1016/j.cpcardiol.2024.102421
10. Al Houri H.N., Jomaa S., Jabra M. et al. Pathophysiology of stress cardiomyopathy: A comprehensive literature review. Ann Med Surg (Lond). 2022;82:104671. DOI: 10.1016/j.amsu.2022.104671
11. Scafa-Udriste A., Horodinschi R.N., Babos M., Dinu B. Diagnostic challenges between takotsubo cardiomyopathy and acute myocardial infarction-where is the emergency? a literature review. Int J Emerg Med. 2024;17(1):22. DOI: 10.1186/s12245-024-00595-4
12. Crea F., Iannaccone G., La Vecchia G., Montone R.A. An update on the mechanisms of Takotsubo syndrome: "At the end an acute coronary syndrome". J Mol Cell Cardiol. 2024;191:1–6. DOI: 10.1016/j.yjmcc.2024.04.009
13. Celeski M., Nusca A., De Luca V.M. et al. Takotsubo Syndrome and Coronary Artery Disease: Which Came First-The Chicken or the Egg? J Cardiovasc Dev Dis. 2024;11(2):39. DOI: 10.3390/jcdd11020039
14. Templin C., Ghadri J.R., Diekmann J. et al. Clinical features and outcomes of takotsubo (stress) cardiomyopathy. N Engl J Med. 2015;373(10):929–938. DOI: 10.1056/NEJMoa1406761
15. Жукова Н.С., Меркулова И.Н., Шахнович Р.М. и др. Эндоваскулярное лечение разрыва межжелудочковой перегородки у больной с синдромом такоцубо. Терапевтический архив. 2019;91(9):115–123. DOI: 10.26442/00403660.2019.09.000363Zhukova N.S., Merkulova I.N., Shakhnovich R.M. et al. Endovascular closure of a ventricular septal defect from Takotsubo Syndrome. Therapeutic Archive. 2019;91(9):115–123 (in Russ.). DOI: 10.26442/00403660.2019.09.000363
This work is licensed under a Creative Commons «Attribution» 4.0 License.
