Takotsubo Cardiomyopathy Following Physical Assault: A Medico-Legal Case Report

Abstract

Introduction:

Takotsubo syndrome accounts for 1 to 3% of acute coronary syndromes. It mainly affects women aged 67 to 70, who are ten times more likely to develop it than men. Diagnosis remains difficult due to its similarity to acute coronary syndrome. We report the case of a young man who presented with precordial trauma, followed by the subsequent development of Takotsubo syndrome.

Objectives:

The objective of this study is to highlight the challenge of establishing a causal link between the initial trauma and Takotsubo syndrome, particularly when several factors may contribute to this pathological condition. A forensic medical expertise was conducted to establish the causal link between the initial trauma and this syndrome and to determine whether the functional impact was temporary or permanent.

Case report:

This rare case reports a young man who was attacked with a screwdriver and admitted to the medical-surgical emergency department in Sidi Bel Abbès (Algeria) with a left anterior chest wound complicated by hemorrhagic shock. Thoracotomy revealed a left atrial wound and hemopericardium. Two weeks after admission, the patient presented with chest pain associated with electrocardiogram abnormalities suggestive of Takotsubo syndrome. A coronary CT scan was normal and confirmed this diagnosis.

Conclusions:

This case highlights the challenge of establishing causality, particularly when several factors may contribute to this pathological condition, as well as the difficulty of determining whether the functional impact is permanent or temporary.