Takotsubo Cardiomyopathy Following Submassive PE
A 74-year-old African American woman presented with troponin leakage and ST-segment elevation in V2-V4 following 12 hours of chest pain (Figure 1). She was transferred to the catheterization laboratory from the emergency department for urgent left-heart catheterization. Coronary angiography showed nonobstructive coronary artery disease, and she was admitted for acute coronary syndrome treatment. She underwent lower extremities venous Doppler that revealed deep venous thrombosis in her right leg. Full-dose heparin infusion was initiated. Transthoracic echocardiography (TTE) was performed on day of admission that showed right ventricular (RV) enlargement and dysfunction with preserved left ventricular (LV) function (Figure 2A, Video 1). Chest computed tomography angiography for ruling out pulmonary embolism was done 2 days after admission and showed bilateral thrombi involving lobar and segmental branches. The Pulmonary Embolism Response Team was activated, and stat TTE was performed per protocol. At this point, TTE showed resolution of RV enlargement and dysfunction. However, acute dilation of apical and mid segments of LV was noted with severe global dysfunction compatible with takotsubo cardiomyopathy (Figure 2B, Video 2). Follow-up TTE in 10 days showed normal RV and LV function (Video 3).
Which of the following statements regarding takotsubo cardiomyopathy is true?