Among patients with takotsubo syndrome (TTS), reverse TTS (rTTS) constitutes 1-23% of all cases reported in the literature. The highest prevalence of rTTS is observed in intracranial hemorrhage, pheochromocytoma and severe infections.
A case report: The authors describe a case of a 65-year-old female with advanced multiple myeloma in whom rTTS was recognized on admission due to streptococcal sepsis. Other possible triggering factors included: anemia, blood transfusion, transient acute renal failure with electrolyte imbalance. ECG showed ST-segment depression in precordial leads and echocardiography revealed severe left ventricular (LV) dysfunction with apical sparing and with decreased ejection fraction (EF) and global longitudinal strain (GLS): 30 % and -10 %, respectively. Daily echocardiography showed gradual normalization of GLS as well as of regional longitudinal strain (RLS) within 8 days. The authors confirm the distinctness of rTTS including clinical, ECG, echocardiographic and laboratory findings and suggest the usefulness of daily longitudinal strain evaluation for LV function recovery monitoring.
Keywords: longitudinal strain; reverse takotsubo syndrome; triggering factors.
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