Scintigraphic Evaluation of Takotsubo Cardiomyopathy

The Takotsubo Cardiomyopathy (TC) also called broken heart syndrome, or stress-induced cardiomyopathy is characterized by the transient ballooning of the apex during systole as result of apical dyskinesia in conjunction with a compensatory hyperkinesia of the base of the left ventricle; in the absence of significant epicardial coronary artery disease. We report a case of TC with the characteristic findings of apical dyskinesia and perfusion abnormalities on gated SPECT which was diagnosed in retrospect after coronary angiography and left ventriculography. This is followed by a brief review of the scintigraphic techniques that have been used in the evaluation of TC. As TC accounts for at least 1-2% of presentations of acute coronary syndromes, increased awareness on the part of interpreting physicians is required for earlier diagnosis in the subset of patients referred for myocardial perfusion imaging.