Renal thromboembolism in tako-tsubo cardiomyopathy in spite of anticoagulation

SummaryAn elderly lady was admitted with chest pain and an electrocardiogram depicting ST segment elevation, indicative of a myocardial infarction. She was treated with intra-venous tissue plasminogen activator. On coronary angiography there was a dilated and akinetic left ventricular apex but no significant coronary artery disease. She was diagnosed with tako-tsubo cardiomyopathy. An echocardiogram performed two days later demonstrated a thrombus in the left ventricular apex. Despite immediate anticoagulation with intravenous unfractionated heparin, she sustained a renal thromboembolic phenomenon.