Question:
A 58-year-old woman developed chest pain after hearing about her son’s accident. Her 2D echocardiogram/MRI shows findings consistent with Takotsubo cardiomyopathy, Troponin T = 1 ng/mL, and normal coronary angiogram. She has no history of drug use. Which of the following statements is true?
A 58-year-old woman developed chest pain after hearing about her son’s accident. Her 2D echocardiogram/MRI shows findings consistent with Takotsubo cardiomyopathy, Troponin T = 1 ng/mL, and normal coronary angiogram. She has no history of drug use. Which of the following statements is true?
Show Hint
The name "Takotsubo" comes from the Japanese word for an octopus trap, which has a wide bottom and a narrow neck. This perfectly resembles the shape of the left ventricle during systole in this condition (apical ballooning with basal hyperkinesia).
Updated On: Sep 3, 2026
- Mostly occurs in postmenopausal females
- She should undergo PTCA
- Lifelong warfarin required
- After 2 weeks, echo shows apical dyskinesia
Show Solution
Verified By Collegedunia
The Correct Option is A
Solution and Explanation
Concept:
The clinical scenario presents a classic case of Takotsubo Cardiomyopathy, also known as "stress-induced cardiomyopathy" or "broken heart syndrome".
It is characterized by transient systolic dysfunction of the apical and/or mid segments of the left ventricle, typically mimicking a myocardial infarction but occurring in the absence of obstructive coronary artery disease.
Explanation:
• Takotsubo cardiomyopathy is classically triggered by a severe psychological or physical stressor (e.g., hearing about a family member's accident, sudden loss of a loved one, or severe acute medical illness).
• The exact pathophysiology involves an intense sympathetic catecholamine surge that stuns the myocardium, particularly the apex where beta-adrenergic receptors are densely concentrated.
• Epidemiologically, the vast majority of cases (nearly 90%) occur in postmenopausal women, likely due to the loss of the protective effects of estrogen on the cardiovascular and sympathetic nervous systems.
• Option (B) is incorrect. The patient has a normal coronary angiogram, meaning there is no atherosclerotic plaque rupture or occlusion. Therefore, Percutaneous Transluminal Coronary Angioplasty (PTCA) or stenting provides no benefit and is not indicated.
• Option (C) is incorrect. Unless a severe complication like an apical mural thrombus develops (which would warrant temporary anticoagulation), lifelong warfarin is not a standard treatment for Takotsubo cardiomyopathy.
• Option (D) is incorrect. A hallmark of Takotsubo cardiomyopathy is its transient nature. The apical dyskinesia or ballooning typically resolves completely, and normal LV function is usually restored within a few weeks to months.
Final answer:
The condition predominantly and characteristically affects postmenopausal females following a severe emotional or physical stressor.
The clinical scenario presents a classic case of Takotsubo Cardiomyopathy, also known as "stress-induced cardiomyopathy" or "broken heart syndrome".
It is characterized by transient systolic dysfunction of the apical and/or mid segments of the left ventricle, typically mimicking a myocardial infarction but occurring in the absence of obstructive coronary artery disease.
Explanation:
• Takotsubo cardiomyopathy is classically triggered by a severe psychological or physical stressor (e.g., hearing about a family member's accident, sudden loss of a loved one, or severe acute medical illness).
• The exact pathophysiology involves an intense sympathetic catecholamine surge that stuns the myocardium, particularly the apex where beta-adrenergic receptors are densely concentrated.
• Epidemiologically, the vast majority of cases (nearly 90%) occur in postmenopausal women, likely due to the loss of the protective effects of estrogen on the cardiovascular and sympathetic nervous systems.
• Option (B) is incorrect. The patient has a normal coronary angiogram, meaning there is no atherosclerotic plaque rupture or occlusion. Therefore, Percutaneous Transluminal Coronary Angioplasty (PTCA) or stenting provides no benefit and is not indicated.
• Option (C) is incorrect. Unless a severe complication like an apical mural thrombus develops (which would warrant temporary anticoagulation), lifelong warfarin is not a standard treatment for Takotsubo cardiomyopathy.
• Option (D) is incorrect. A hallmark of Takotsubo cardiomyopathy is its transient nature. The apical dyskinesia or ballooning typically resolves completely, and normal LV function is usually restored within a few weeks to months.
Final answer:
The condition predominantly and characteristically affects postmenopausal females following a severe emotional or physical stressor.
Was this answer helpful?
0
0
Top NEET SS Medical Questions
- A liver transplant patient presents with diarrhoea, colitis, a total leukocyte count of 1800, and a positive blood CMV PCR. What is the next step in management?
- A 32-year-old male recovering from dengue fever initially showed clinical improvement but now presents with recurrence of high-grade fever, fatigue, and pancytopenia on day 10 of illness. He is hemodynamically stable with no bleeding manifestations. Which of the following investigations should be performed first to evaluate the cause of relapse and cytopenia?
- A 48-year-old man with chronic hepatitis C infection is being evaluated for risk factors associated with progression of liver disease. He has a 20-year history of infection, drinks alcohol occasionally, and has a high serum HCV RNA viral load. Which of the following factors is not associated with an increased risk of progression of liver disease in chronic HCV infection?
- A 28-year-old veterinary worker who previously received a full 3-dose pre-exposure rabies vaccination series is bitten by a stray dog while handling an animal in the clinic. The wound is cleaned immediately. What is the most appropriate post-exposure management?
- A 42-year-old patient undergoing chemotherapy for acute myeloid leukemia develops neutropenia (ANC $<$ 500) and is treated with broad-spectrum antibiotics. After initial recovery of neutrophil counts (ANC = 1500), he again develops high-grade fever and right upper quadrant abdominal pain. Imaging shows multiple small hypodense lesions in the liver and spleen. What is the most likely diagnosis?
View More Questions
Top NEET SS Cardiology Questions
- An ECG was performed as part of a routine cardiac evaluation. Based on the findings, which of the following is the most likely cause of the abnormal pattern?
- A 21-year-old man presents with sudden onset chest pain. His ECG shows ST-segment elevation in leads II, III, aVF, V5, and V6, and echocardiography reveals concentric left ventricular hypertrophy. What is the most likely cause?
- The following diagram represents which of the following valvular heart diseases?
- Which of the following statements regarding Cardiac Resynchronization Therapy (CRT) is correct?
- A young patient presents with syncope and a family history of sudden cardiac death in a sibling at a young age. Which of the following statements regarding management is true?
View More Questions
Top NEET SS Questions
- A liver transplant patient presents with diarrhoea, colitis, a total leukocyte count of 1800, and a positive blood CMV PCR. What is the next step in management?
- A 32-year-old male recovering from dengue fever initially showed clinical improvement but now presents with recurrence of high-grade fever, fatigue, and pancytopenia on day 10 of illness. He is hemodynamically stable with no bleeding manifestations. Which of the following investigations should be performed first to evaluate the cause of relapse and cytopenia?
- A 48-year-old man with chronic hepatitis C infection is being evaluated for risk factors associated with progression of liver disease. He has a 20-year history of infection, drinks alcohol occasionally, and has a high serum HCV RNA viral load. Which of the following factors is not associated with an increased risk of progression of liver disease in chronic HCV infection?
- A 28-year-old veterinary worker who previously received a full 3-dose pre-exposure rabies vaccination series is bitten by a stray dog while handling an animal in the clinic. The wound is cleaned immediately. What is the most appropriate post-exposure management?
- A 42-year-old patient undergoing chemotherapy for acute myeloid leukemia develops neutropenia (ANC $<$ 500) and is treated with broad-spectrum antibiotics. After initial recovery of neutrophil counts (ANC = 1500), he again develops high-grade fever and right upper quadrant abdominal pain. Imaging shows multiple small hypodense lesions in the liver and spleen. What is the most likely diagnosis?
View More Questions