Data Sheet 1_Case Report: Stepwise noninvasive diagnosis of Takotsubo cardiomyopathy in an elderly patient–From ECG clues to echocardiographic and CTA confirmation.pdf

BackgroundTakotsubo cardiomyopathy (TTC) is frequently misdiagnosed as acute coronary syndrome in elderly patients. This case demonstrates how ECG findings facilitate a noninvasive diagnostic algorithm for TTC, validated by echocardiography and coronary computed tomography angiography (CCTA).
Case summaryAn 88-year-old woman presented with chest tightness and dyspnea after emotional stress (bereavement). Initial ECGs showed the concurrent appearance of ST-segment elevations in anterior (V3-V5) and inferior leads (II, III, aVF), suggesting apical injury and the diagnosis of TTC. Bedside echocardiography revealed apical akinesis with preserved basal contraction (LVEF 35%), while CCTA ruled out obstructive disease. Supportive therapy led to symptom resolution. At 1-year follow-up, LVEF recovered to 61% with normalized ECG.
ConclusionThis case highlights ECG's pivotal role in suspecting TTC, enabling a Noninvasive diagnostic approach (echocardiography + CCTA) for elderly patients.