Tako-tsubo-like left ventricular dysfunction in a patient with chronic total occlusion of the left anterior descending artery

This report describes a case of tako-tsubo-like left ventricular dysfunction in a patient with chronically occluded left anterior descending artery. A 74-year-od female, experiencing severe pain due to osteoarthritis, presented with chest pain lasting for 6 h. Electrocardiography revealed ST-segment elevation in the anterior and lateral walls. Left ventriculography in the acute phase displayed an akinetic apex and hyperkinetic basal region. Emergent coronary angiography revealed total occlusion of the left anterior descending artery. Although direct coronary angioplasty to the totally occluded left anterior descending artery was unsuccessful, the left ventricular function returned to normal within three weeks after admission. Thallium scintigraphy showed no significant abnormality, and cardiac enzyme elevation showed only a slight increase. In this case, tako-tsubo-like left ventricular dysfunction was considered to occur in the presence of chronically occluded left anterior descending artery.