Role of MIBG scintigraphy in reverse tako-tsubo cardiomyopathy: confirming a pathophysiologic hypothesis

A 40-year-old woman dyslipidemic, ex-smoker, was admitted to the Emergency Department for syncope associated to a severe oppressive pain in epigastric region. Electrocardiogram (EKG) showed an ST-segment depression in anterior-lateral leads. An increase of myocardio-necrosis markers was also observed. A trans-thoracic echocardiogram showed a reduced global systolic function (FE 37%) and a basal-medium dyskinesia. Coronary angiography showed normal coronary arteries. The left ventriculography and cardiac magnetic resonance (CMR) imaging confirmed the echocardiographic findings: depressed global systolic function with diskinesia of the basal and middle segments