Persistent Apical Akinesis Following Takotsubo Syndrome With Marked Troponin Elevation: A Case Report
- 1Cardiology, Patel Cardiovascular Consultants, Langhorne, USA
- 2Otolaryngology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, USA
Abstract
Takotsubo syndrome (TTS) is typically characterized by transient left ventricular (LV) systolic dysfunction with recovery occurring within days to weeks. Persistent regional wall motion abnormalities beyond the expected recovery period are uncommon. We report the case of a 77-year-old woman who presented with nausea, vomiting, epigastric discomfort, dyspnea, ST-segment depressions, and markedly elevated high-sensitivity troponin (9,848 ng/L). Coronary angiography demonstrated nonobstructive coronary artery disease, while echocardiography confirmed TTS with apical akinesis and an LV ejection fraction of 35%. A large hiatal hernia was also identified. Although the patient experienced complete symptomatic recovery and returned to baseline functional status, serial echocardiography demonstrated persistent apical akinesis through four months of follow-up. This case highlights an unusual recovery pattern in TTS and demonstrates that marked troponin elevation can occur despite nonobstructive coronary artery disease.
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BibTeX
@article{mishra2026persistent,
title = {{Persistent Apical Akinesis Following Takotsubo Syndrome With Marked Troponin Elevation: A Case Report}},
author = {Shreyas Mishra and Mrugesh B Patel and David Crowder and Sahil Sharma},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117114},
url = {https://europepmc.org/article/PMC/PMC13717256},
note = {CC BY},
}
RIS
TY - JOUR
TI - Persistent Apical Akinesis Following Takotsubo Syndrome With Marked Troponin Elevation: A Case Report
AU - Shreyas Mishra
AU - Mrugesh B Patel
AU - David Crowder
AU - Sahil Sharma
PY - 2026
DA - 2026/09/28
JO - Cureus
DO - 10.7759/cureus.117114
UR - https://europepmc.org/article/PMC/PMC13717256
AB - Takotsubo syndrome (TTS) is typically characterized by transient left ventricular (LV) systolic dysfunction with recovery occurring within days to weeks. Persistent regional wall motion abnormalities beyond the expected recovery period are uncommon. We report the case of a 77-year-old woman who presented with nausea, vomiting, epigastric discomfort, dyspnea, ST-segment depressions, and markedly elevated high-sensitivity troponin (9,848 ng/L). Coronary angiography demonstrated nonobstructive coronary artery disease, while echocardiography confirmed TTS with apical akinesis and an LV ejection fraction of 35%. A large hiatal hernia was also identified. Although the patient experienced complete symptomatic recovery and returned to baseline functional status, serial echocardiography demonstrated persistent apical akinesis through four months of follow-up. This case highlights an unusual recovery pattern in TTS and demonstrates that marked troponin elevation can occur despite nonobstructive coronary artery disease.
SN - 2168-8184
ER -