Left ventricular free wall rupture in a Caucasian female with Takotsubo syndrome: a case report and a brief literature review.

The takotsubo syndrome is a clinical entity that can mimic an acute myocardial infarction. It is characterised by anginal chest pain with ST-T elevation in precordial leads, without coronary obstruction at angiography; its distinctive feature is a peculiar pattern of left ventricular contraction, with expansion of the apical segments and basal hyperkinesis, also known as 'apical ballooning'. This syndrome usually has a good prognosis, with normalisation of the left ventricular contraction impairment within several days, although Japanese authors have described two cases of free left ventricular wall rupture in these patients.We describe a case of apical ballooning syndrome complicated by left ventricular rupture in a Caucasian old female. To our knowledge, this is the first-ever case of a fatal outcome in the Caucasian population, due to free wall ventricular rupture, and confirms that the takotsubo syndrome may lead to a fatal cardiac event.