ST-segment deviation pattern of takotsubo cardiomyopathy similar to acute pericarditis: diffuse ST-segment elevation

Abstract

Background: Possible similarities or differences in the ST- and PR-segment deviations in the electrocardiogram of takotsubo cardiomyopathy (TTC) and acute pericarditis (AP) are not well defined.

Methods: We compared different parameters of the admission electrocardiogram in eight patients with TTC and eight patients with AP with ST-segment elevation in the acute phase.

Results: We found significant differences in the maximal magnitude of the T wave in the precordial leads, but not in the ST- and PR-segment deviation patterns between the two patient groups. All the patients in the two groups showed consistent ST-segment depression in lead aVR and absence of ST-segment elevation in lead V1.

Conclusions: The ST- and PR-segment deviation patterns in TTC are similar to that of AP, namely diffuse ST-segment elevations with reciprocal changes in aVR and V1 and PR-segment elevation in aVR accompanied by PR-segment depression in the inferior leads, possibly indicating that TTC has ECG characteristics of circumferential subepicardial ischemia in the acute phase.