Takotsubo Cardiomyopathy Mimicking Obstructive Hypertrophic Cardiomyopathy

Takotsubo cardiomyopathy (TCM) is characterized by a transient left ventricular dysfunction which can be diagnosed by echocardiography or left ventriculography. There is an emotional, physical, or combined trigger in most cases. Acute coronary syndrome is one of the most frequent misdiagnoses in TCM patients regarding ECG abnormalities and elevation of cardiac biomarkers. Coronary angiography generally shows no coronary artery stenosis or occlusion. Hypertrophic cardiomyopathy (HCM) is an utterly different pathology characterized by a hypertrophied left ventricle with various phenotypes. However, a few reports also reported TCM mimicking obstructive-type HCM in some patients. Herein, we reported a female patient in whom TCM was diagnosed based on clinical, laboratory, and imaging tests. However, the ventriculography and echocardiography findings were challenging to differentiate the TCM from HCM, as the hyperdynamic contraction of the basal segments of the left ventricle produced an increased left ventricular outflow tract (LVOT) gradient and severe mitral valve regurgitation. Detailed evaluation and close follow-up with echocardiography are required in such a rare case to differentiate TCM from HCM.