Isolated right ventricular takotsubo cardiomyopathy presenting as acute right ventricular failure: A case report

Background: Takotsubo cardiomyopathy (TTC) is a non-ischaemic cardiomyopathy, characterized by transient wall motion abnormalities of the left ventricle. Although biventricular involvements are common with a poor prognosis, isolated right ventricular (RV) involvement of TTC is a rare, and its diagnosis remains challenging.Case presentation: We encountered a case of isolated RV-TTC presenting as acute RV failure, with progression to cardiogenic shock requiring intensive treatment. Conflicting echocardiographic findings of RV asynergy with RV enlargement despite normal left ventricular wall motion and mild tricuspid regurgitation led to the correct diagnosis. Finally, the patient showed complete recovery with normalization of cardiac structure and function.Conclusions: This case underscores the clinical significance of considering isolated RV-TTC as a new distinct variant form of TTC in terms of presentation, diagnostic findings, differential diagnosis, treatment strategy, and prognosis.

Automated summary

This is a rare and difficult-to-diagnose case of isolated right ventricular Takotsubo cardiomyopathy. The patient presented with acute right ventricular failure, progressing to cardiogenic shock requiring intensive treatment. Conflicting echocardiographic findings of right ventricular asynergy with right ventricular enlargement despite normal left ventricular wall motion and mild tricuspid regurgitation led to the correct diagnosis. Finally, the patient showed complete recovery with normalization of cardiac structure and function.