The fifth takotsubo variant

We document the fifth pattern of takotsubo cardiomyopathy, in which the mid‐LV is hyperdynamic but the apex and base are akinetic or hypokinetic. This is a reverse mid‐ventricular takotsubo. The patient is a 79‐year‐old woman admitted with chest pain and initially a normal EKG. Her troponin I rose to 5.4 μg/L (0.02‐0.03 μg/L) and she developed QT prolongation and widespread T‐wave inversion. Coronary angiography showed only very mild atheroma. Follow‐up echocardiogram six weeks later showed normal left ventricular function.