DOI: 10.36347/sjams.2020.v08i02.046

Pages: 618-622

Introduction: Takotsubo cardiomyopathy is characterized by transient systolic dysfunction of LV apical segments mimicking myocardial infarction in the absence of obstructive coronary involvement. It represents about 1.2% of all acute coronary events. Inverted Takotsubo is a very rare variant in which kinetic disorders interest the base and middle segments of the LV. We present the case of a patient with an inverted takotsubo with literature review. Case Report: Patient of 63 years, Frcvx: Dyslipidemia and DT2 under treatment, who consults at J2 with a retroternal acute chest pain without irradiation, prolonged >45 min following an emotional shock (death in the family). At admission, the patient is conscious, no longer suffering, TA=150/60, FC=90, FR=15, SPO2:98%, cardiovascular and pleuropulmonar examination were without abnormalities. The rest of the exam was clean. The patient benefited from an initial ECG that showed T(-) waves in Anteroseptoapical and lateral low with a steep ST segment below, the diagnosis of an NSTEMI is taken then put on the dose of Clopidogrel and aspirin then send to the hospital, upon its arrival the patient has benefited from an ECG that shows the same aspect in ASA, but T(+) waves in the lower lateral and lower, subcutaneous initiation of anticoagulation. The next day the ECG showed positive ASA waves T. The initial troponin was 600xN, then 60xN, then 50xN. Echocardiography shows kinetic disorders of the basal and middle segments, a 48% impaired LVEF, and a 10% SLG, the patient received a coronary artery that returned normal, Control echocardiography after a week showed improvement in contractility, LV function and strain, MRI returned normal. Conclusion: Inverted takotsubo is a very rare variant of classical takotsubo with similar physiopathological symptoms and mechanisms, important to identify as it tends not to be recognized as easily as traditional presentation. Its recognition helps improve prognosis.