Midventricular takotsubo syndrome: different dyskinesia location leading to a different electrocardiogram?

Abstract Funding Acknowledgements Type of funding sources: None. Background Takotsubo syndrome (TKS) is characterized by the appearance apical reversible dyskinesia in its typical form. Electrocardiogram (ECG) acute phase (<12 from symptom onset) generally shows anterior ST segment elevation. Nonetheless, other atypical forms TKS have been described depending on location dyskinetic segments, such as, mid-ventricular, basal and focal forms. Considering different segments involved these forms, it seems reasonable to consider that changes ECG could be different. Purpose To compare versus mid-ventricular TKS, as was more frequent form our registry. Methods Patients included prospective registry center according Mayo Clinic diagnostic criteria, with first performed less than 12 hours symptoms onset were reviewed. All cardiac left ventriculographies reviewed ensure a correct classification types TKS. Results A total 297 patients local 80 met study inclusion criteria. 56 ECGs compared 24 midventricular There no differences between baseline characteristics both groups, except for frequently triggered physical stressor. Regarding analysis, main difference found serie related ST-segment deviation (Table 1). While elevation common (73% vs 50%), depression (generally inferior leads) observed 54% patient (figure Conclusion The associated significant obtained after clinical symptoms. presence highly suggestive characteristicsTypical (n = 56)Midventricular 24)pSTe > 1mm, (%)41 (73)12 (50)0,044STd >0,5 mm, (%)013 (54)< 0,001T wave inversion, (%)12 (21)4 (17)0,626Q wave, (%)22 ( 39)12 (50)0,374cQT, mean (SD)445 (54)438 (37)0,578QRS low voltages*, n (%)9 16)1 (4)0,328STe elevation, STd: depression, cQT: corrected QT interval *Voltages <5mm all limb leads or <10mm precordial Figure. 12-lead ventriculography