An atypical case of Takotsubo cardiomyopathy in a middle-aged male triggered by work-related stress: case report

Takotsubo cardiomyopathy (TCM) is a reversible cardiomyopathy that mimics acute coronary syndrome and is most commonly observed in postmenopausal women following emotional stress. Presentation in middle-aged men is uncommon, and occupational stress is an increasingly recognized but underreported trigger.

A 55-year-old male with Type 2 diabetes mellitus, hypertension, and dyslipidaemia presented with prolonged mild central chest discomfort following an exceptionally long and stressful workday organizing a sporting event. High-sensitivity troponin T was elevated, and transthoracic echocardiography demonstrated reduced left ventricular ejection fraction with apical and mid-ventricular hypokinesia and basal sparing. Coronary angiography revealed no obstructive coronary artery disease. Repeat echocardiography showed near-complete recovery of left ventricular function within 3 days and complete normalization at 6-month follow-up.

This case illustrates an atypical presentation of TCM in a middle-aged male precipitated by prolonged occupational stress. It underscores the importance of considering TCM in patients presenting with acute coronary syndrome-like symptoms irrespective of sex and highlights work-related stress as a significant non-traditional trigger.