Cardiac MRI effective in diagnosing rare 'broken heart syndrome'

Australian researchers found cardiac MRI an accurate method of diagnosing mid-cavity variant Takotsubo cardiomyopathy (TCM)—a rare acute coronary syndrome also known as "broken heart syndrome"—in a case study published in Current Problems in Diagnostic Radiology.

The rare condition often presents in post-menopausal women and is triggered by a physical or emotional stressor. TCM is often confused with acute myocardial infarction, making proper imaging important for radiologists.

In this study, authors looked at the case of a 56-year-old woman who came to the emergency department (ED) with chest pain and a history of Hashimoto’s thyroid disease.

After giving the woman an electrocardiography, providers determined a coronary angiogram and left ventriculogram (LV gram) were necessary. These tests demonstrated symptoms consistent with mid-cavity variant TCM, which was then conformed with a cardiac MRI.

While authors acknowledge echocardiography often plays a key role in diagnosing TCM, the method is unable to produce the hallmark variants of TCM including diffuse LV wall edema isolated to the mid-septum that can be confirmed with cardiac MRI.

“Cardiac MRI offers a noninvasive method that can differentiate between conditions such as myocarditis, myocardial infarction and TCM as well as identifying the extent of the disease,” wrote Katrina Newbigin, with Wesley Medical Imaging at the Wesley Hospital in Australia, and colleagues. “Cardiac MRI also has clinical use in identifying complications of TCM that may be missed on other imaging modalities such as dynamic obstruction of LV outflow and LV thrombus formation.”