'Acute micro-coronary syndrome': detailed coronary physiology in a patient with Takotsubo cardiomyopathy

Morrow, A. , Nordin, S., O'Boyle, P. and Berry, C. (2019) 'Acute micro-coronary syndrome': detailed coronary physiology in a patient with Takotsubo cardiomyopathy. BMJ Case Reports, 12, e229618. (doi: 10.1136/bcr-2019-229618) (PMID:31466973)

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Takotsubo cardiomyopathy (TC), otherwise known as stress cardiomyopathy, is characterised by acute, transient left ventricular systolic dysfunction with apical ballooning in the absence of obstructive epicardial coronary stenosis. The presentation of TC mimics that of acute myocardial infarction. More recently there has been a shift towards thinking of TC as a ‘microvascular acute coronary syndrome’. Our case is of an 82-year-old woman who presented with TC mimicking acute anterior ST elevation myocardial infarction in the context of sepsis. Slow flow noted in the left anterior descending artery prompted us to perform coronary physiology. Her fractional flow reserve was 0.91, with an index of myocardial resistance of 117 and a coronary flow reserve of 1.6. In combination these results are indicative of microvascular coronary dysfunction in the absence of significant epicardial stenosis.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Morrow, Dr Andrew and Berry, Professor Colin
Authors: Morrow, A., Nordin, S., O'Boyle, P., and Berry, C.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:BMJ Case Reports
Publisher:BMJ Publishing Group
ISSN (Online):1757-790X
Published Online:28 August 2019
Copyright Holders:Copyright © BMJ Publishing Group Limited 2019
First Published:First published in BMJ Case Reports 12:e229618
Publisher Policy:Reproduced under a Creative Commons license

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
617771BHF centre of excellenceRhian TouyzBritish Heart Foundation (BHF)RE/13/5/30177RI CARDIOVASCULAR & MEDICAL SCIENCES