[Tako-tsubo-like transient left ventricular dysfunction with apical thrombus formation: a case report].

A 76-year-old woman with oppressive chest pain was admitted to our hospital. Initial electrocardiography revealed normal sinus rhythm with ST-segment elevation in leads V2-V5. The patient underwent emergent coronary angiography, which demonstrated no significant coronary stenosis. Left ventriculography revealed marked hypokinesis and akinesis of the mid and distal segments of all ventricular walls, with hyperkinesis of the base. Six days after admission, transthoracic echocardiography revealed immobile apical thrombus. The thrombus disappeared without any embolic episode after 2 weeks of anticoagulant therapy with heparin and warfarin. Left ventricular walls returned to normal 3 months after the attack. Tako-tsubo-like cardiomyopathy with apical thrombus has only been reported in three cases. Left ventricular function normalizes within several days or weeks in most cases of tako-tsubo-like transient left ventricular dysfunction. Therefore, if the thrombus remains within the left ventricle, the risk of embolism might be relatively high. Careful management must be required in patients with tako-tsubo-like transient left ventricular dysfunction.