ECG case series for paramedics: August 2023

This 52-year-old lady normally keeps fit and well. She has had hypertension for 15 years but this is usually well controlled.

She has been experiencing a lot of stress at home lately, having just separated from her husband. Her son was also badly injured in a road traffic accident 2 weeks ago.

This morning, she was awakened with heavy, central chest pain that radiated down both upper arms and into her jaws. She felt clammy and neaseous. Her daughter immediately called 999.

The 12-lead ECG pictured in Figure 1 was recorded at the scene.

The woman was triaged to the cardiac catheterisation laboratory for emergency primary percutaneous coronary intervention. However, her coronary arteries were found to be normal. Her left ventricular gram showed classical features of Takotsubo cardiomyopathy.

Takotsubo are traditional ceramic vases that are used by Japanese fishermen to catch octopus. They have a narrow neck and wide base.

Other terminology for Takotsubo cardiomyopathy includes: