PMC6197003_01
Ascending colon mass-related with Takotsubo Cardiomyopathy. A) Large malignant-looking mass of the ascending colon on colonoscopy. B) Large focal density within the proximal ascending colon on CT abdomen and pelvis with contrast.
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On the seventh day of admission, she underwent diagnostic colonoscopy which showed diverticulosis with local infection, two sessile polyps in the transverse and sigmoid colon (SC), and a large malignant appearing mass of the proximal ascending colon (Figure 1(a)). Because of a possible colon malignancy, a CT with contrast of chest, abdomen and pelvis was performed for staging in which a focal density measuring 4 cm x 2.4 x 3.9 cm was found within the proximal ascending colon (Figure 1(b)).
Takotsubo cardiomyopathy-triggered by the ascending colon mass. A) Mid to distal apical ballooning of the left ventricle on transthoracic echocardiogram. B) Angiography showing non-obstructive coronary arteries.
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Transthoracic echocardiogram (TTE) showed mildly increased left ventricle (LV) cavity size, regional wall motion abnormalities (mid to apical akinesis) and an ejection fraction (EF) of 35% decreased from the baseline of 60% reported eight months prior (Figure 2(a)). Because of this NSTEMI and prior VT-arrest, a cardiac catheterization was performed (Figure 2(b)) which ruled out significant CAD.