Takotsubo's

The above TTE was a apical 4 chamber view that showed apical ballooning consistent with Tatoksubo’s cardiomyopathy! Sometimes it’s hard to tell what the ventricular walls are doing to the untrained generalists eyes. One cardiologist’s tip was to place your finger in the middle of the chamber and isolate each walls movement in reference to your finger. When you do that, you can definitely see that the walls in the apex are not moving at all and are ballooned out. See the fig to the right.

Takotsubo’s is an important item to keep on your differential when seeing patients with chest pain as 1-2% of troponin-positive suspected ACS patients have this stress induced cardiomyopathy.

Can you identify the view on the TTE above? Can you identify which chambers are which? Did this look abnormal to you? If the answer is “no” to any of these - check out these lectures on echos!