Recurrent Focal-type Takotsubo Syndrome Following Prior Mid-ventricular Variant

We report an extremely rare case of recurrent Takotsubo syndrome (TTS) in an 83-year-old woman who initially experienced the mid-ventricular type and later developed the focal type. TTS is a transient cardiac condition that mimics acute coronary syndrome but lacks obstructive coronary lesions. While recurrence is uncommon, a change in morphological subtype is particularly rare. In this case, echocardiography was inconclusive, and the diagnosis was confirmed via left ventriculography. This case highlights the diagnostic challenges of focal-type TTS and emphasizes the importance of comprehensive imaging, especially left ventriculography, in patients with suspected recurrence and inconclusive non-invasive findings.