Left Ventricular Rupture Associated With Takotsubo-like Left Ventricular Dysfunction (Apical Ballooning)

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A 71-year-old woman was admitted with sudden-onset shoulder and back pain. The electrocardiograph showed sinus rhythm with ST-segment elevation in leads V_4-6 and abnormal Q waves in leads V_4-5. Echocardiography at the time of admission revealed akinesis in the left ventricular apical wall. However, coronary angiography did not reveal a stenotic lesion in any of the coronary arteries. Left ventriculography revealed apical ballooning with basal hyperkinesis. Ten hours after onset, the patient suddenly collapsed and went into cardiopulmonary arrest. This is a rare case of left ventricular rupture with takotsubo-like left ventricular dysfunction.