614 Introduction Tako-tsubo cardiomyopathy is a new syndrome, first described by Sato et al. 1,2 in 1990, which is characterized by transient left ventricular (LV) dysfunction with chest pain and specific electrocardiographic changes 3 . In these patients, a typical left ventricu- logram shows transient extensive akinesis of the apical and mid portions of the left ventricle with hypercontraction of the basal segment 4 , from which this disease takes its name. In Japanese language “tako-tsubo” is a fishing pot with a round bottom and a neck that is used for trapping octopuses. Since 1990 sporadic cases of tako-tsubo cardiomyopathy were reported by Japanese authors, and only a few European reports are available 3-15 . We present the cases of 2 Caucasian patients affected by this syn- drome. Description of cases Case 1. A 67-year-old female patient was admitted for epigastric pain. She did not show any cardiovascular risk factors. The patient’s clinical history revealed an episode of superficial phlebitis at the right inferior limb, 1 month before admission; moreover, a few days prior to admission she had a car accident described as a very emotionally stressful event. At admission she was in good clinical conditions. The clinical examination was negative. ECG showed ST-segment elevation in DI and aVL and T-wave inversion in all leads (Fig. 1). Blood tests revealed normal myocardial enzyme levels and an increase in inflammatory indices (erythrocyte sedi- mentation rate, C-reactive protein, and be- ta 2 -globulins). We did not detect any virus causing myocarditis. An increased level of vanilmandelic acid was detected. During in-hospital stay, ECG showed a progressive deepening of negative T wave in leads that explore the lateral segments of the left ven- tricle. Echocardiography, at that time, showed a global LV akinesis with basal re- gional hyperkinesis and an ejection frac- tion of about 40%. The patient underwent a cardiac catheterization that showed normal coronary arteries and an enlarged left ven- tricle with global akinesis and basal hyper- kinesis (ejection fraction 40%), according to echocardiographic data. Figure 2 shows the characteristic angiographic image known in the literature as “tako-tsubo”. At discharge a treatment with enalapril and di- uretics was prescribed. One month later the patient was readmit- ted for clinical and instrumental evaluation. The patient was in good clinical conditions. Blood tests confirmed the absence of viral myocarditis. The level of vanilmandelic acid was within normal limits. An echocardio- gram showed complete global and segmen- tary kinesis normalization and an improved cardiac function (ejection fraction 70%). Key words: Left ventricular dysfunction; Stunned myocardium. © 2005 CEPI Srl Received September 23, 2004; revision received March 2, 2005; accepted March 4, 2005. Address: Dr. Giovanni Fazio Via S. Maria del Gesù, 25 90124 Palermo E-mail: Giovanni.fazio-aaaa@ poste.it Two cases of tako-tsubo cardiomyopathy in Caucasians Pasquale Assennato, Rosa Alfano, Giuseppina Novo, Giovanni Fazio, Rosanna Zito, Dalila Fernandez, Gabriella Carlino, Loredana Sutera, Marco Fazio, Enrico Hoffmann, Salvatore Novo Department of Cardiology, University of Palermo, Palermo, Italy Tako-tsubo cardiomyopathy is a recently described disease characterized by chest pain, transient left ventricular dysfunction and specific electrocardiographic changes. The disease takes its name from the typical left apical ballooning observed at left ventriculogram. Tako-tsubo cardiomyopathy was first described by Sato in 1990. Since then sporadic cases were reported by Japanese authors, and only a few European publications are available. We describe 2 cases of patients affected by this syn- drome. (Ital Heart J 2005; 6 (7): 614-617)