Recurrent takotsubo cardiomyopathy with variant forms of left ventricular dysfunction.

A 78-year-old man presented to our emergency department with dyspnea. The patient was diagnosed as having pneumonia from the chest X-ray which depicted mass-like opacity in the left lower lobe. On the 5th hospital day, electrocardiography showed giant negative T waves in pericardial leads and echocardiography demonstrated left ventricular apical akinesis and basal hyperkinesis. Accordingly, the patient was retrospectively diagnosed as having typical takotsubo cardiomyopathy. Two years later, the patient was admitted again to our hospital with pneumonia. On the 2nd hospital day, echocardiography showed left ventricular basal and mid-ventricular akinesis combined with normal apical wall motion. Ventricular wall motion was normalized within two months. The patient was finally diagnosed as having inverted takotsubo cardiomyopathy. Here, we report the patient who had recurrent takotsubo cardiomyopathy with variant forms of left ventricular dysfunction caused by repeated physical stress in two years.