Journal of Nuclear Cardiology

, 16:999 | Cite as

Reverse Takotsubo syndrome diagnosed with Tc-99m SPECT perfusion study

  • Michael DavisEmail author
  • Charles Hardebeck
Nuclear Cardiology Bullet

We present a case of a critically ill man admitted to the intensive care unit with acute respiratory failure with anoxic encephalopathy and elevated cardiac biomarkers. The patient underwent myocardial perfusion scintigraphy demonstrating fixed midventricular and basal circumferential areas of hypoperfusion and hypokinesis with preservation of the ventricular apex. Due to the anatomical distribution of the specific defects a diagnosis of atypical stress-induced cardiomyopathy or reverse Takotsubo syndrome was made highlighting the importance of recognizing this uncommon entity when imaged by nuclear perfusion studies.

Case Presentation

49-year-old black male was admitted to the intensive care unit after being discovered unconscious in a park with hypercarbic and hypoxic respiratory failure requiring mechanical ventilatory support. He was treated for pneumonitis and started on antibiotics. Laboratory data revealed an elevated troponin level with a peak value of 1.4 mg/dL 24 hours after...


Single Photon Emission Compute Tomography Single Photon Emission Compute Tomography Imaging Myocardial Perfusion Scintigraphy Stress Cardiomyopathy Takotsubo Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 1

Echocardiographic cine images, indicating basilar left ventricular hypokinesis (WMV 1833 kb)

Video 2

Gated SPECT cine, demonstrating impaired wall motion/thickening throughout basilar regions (WMV 568 kb)


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Copyright information

© American Society of Nuclear Cardiology 2009

Authors and Affiliations

  1. 1.Division of Cardiovascular MedicineOhio State University Medical CenterColumbusUSA
  2. 2.Department of Internal MedicineOhio State UniversityColumbusUSA

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