Transient Inferior Left Ventricular Dyskinesia: A New Tako- Tsubo Variant?

Apical transient dyskinesia, presents features mimicking acute coronary syndrome, being their characteristics normal coronary arteries assessed by coronariography and the complete resolution of the motion alterations. We report 6 white patients who presented with inferior left ventricular wall involvement. A thorough chart review combined with a clinical and echocardiographic follow-up was performed. The inclusion criteria were Mayo criteria. Four patients (67%) were women; and the mean age was 54 years. Emotional stress situation was associated in 2 patients. Electrocardiographic changes were displayed in all of them. A complete left ventricular motion recovery was displayed in 100% by means of echocardiography. Mean follow-up was 9,5 months. One patient developed an asymptomatic myocardial infarction during the follow-up. This case series supports the idea that an inferior left ventricular involvement of this cardiomyopathy could exist. Its probable relationship with the typical form of Tako-tsubo raises further questions about the pathophysiology, prognosis and management.