A concealed case of takotsubo syndrome as consequence of ab ingestis episode in a revascularized patient

We report the case of secondary Takotsubo syndrome as a consequence of an ingestis episode in an elderly woman with a history of myocardial revascularization and ischemic stroke with residual emiparesis and dysphagia. Particularly, the invasive coronary angiography showed the left internal mammary artery bypassing a myocardial bridge in the context of a non-severely stenotic coronary artery disease (CAD). Moreover, atypical biventricular wall motion abnormalities were found at the first echocardiographic assessment. We hypothesize that post-ischemic dysphagia may lead to cardiac consequences likely comparable to those of near-drawing syndrome, even though in this specific case a concomitant linked mechanism to myocardial bridging cannot be excluded.