Coronary artery systolic “milking” and “bridging” in Takotsubo syndrome: substrate or an epiphenomenon?
[first paragraph of article]
To The Editor:
I enjoyed reading the case report by Spadotto et al. published in issue 2 (2013) of the Journal about a 66-year-old woman with Takotsubo syndrome (TTS), involving the mid-apical segment of the left ventricle (LV), severe dynamic mid-ventricular gradient and mitral regurgitation, with systolic anterior motion of the anterior mitral leaflet caused by the hyperkinetic basal segments, with generation of a peak intra-ventricular gradient of 48 mmHg, and mild systolic “milking” of the mid to distal segment of the left anterior descending coronary artery (LAD). Cardiac magnetic resonance imaging (cMRI) showed intense myocardial edema of the mid-apical LV segments.
This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.