Ventricular Septal Perforation Following Takotsubo Cardiomyo
Case Report

Ventricular septal perforation is a well-known complication following acute myocardial infarction, but it has rarely complicated takotsubo cardiomyopathy [1].

We report a rare case of ventricular septal perforation after takotsubo cardiomyopathy (TCM-VSP), which was successfully treated by surgery.

A 76-year-old woman was admitted for bowel obstruction caused by an ascending colon tumor. The patient was under treatment for hypertension and diabetes. Dyspnea occurred after three days. Electrocardiography showed ST elevation in leads V1-V6. The elevation suggested acute myocardial infarction and coronary arteriography was performed. No coronary lesion was present (Figure 1), but an absence of apical contraction and an excessive base contraction were noted on the left ventriculography (Figure 2). Takotsubo cardiomyopathy was diagnosed. The symptoms improved after inpatient treatment, but there was sudden onset of severe dyspnea after four days. Levine 4/6 pansystolic murmur that was loudest at the apex was heard. Transthoracic echocardiography revealed shunt flow from the left ventricle to the right ventricle (Figure 3). TCM-VSP was diagnosed. Intra-aortic balloon pumping was immediately started....