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Persistent Apical Akinesis Following Takotsubo Syndrome With Marked Troponin Elevation: A Case Report

Year: 2026

Type: article

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.

Source: Cureus

DOI: 10.7759/cureus.117114

Authors: Shreyas Mishra, Mrugesh B Patel, David Crowder, Sahil Sharma

Institutions: Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center

Language: English

Topic: Takotsubo Cardiomyopathy and Associated Phenomena

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7214786549