Key result
Antiviral and supportive therapies reverse atypical Takotsubo cardiomyopathy linked to severe HSV-1 encephalitis.
This case highlights the importance of considering cardiac involvement, such as atypical Takotsubo cardiomyopathy, in patients with severe encephalitis.
May warrant cardiac evaluation in severe HSV-1 encephalitis; leaves open causality and generalizability.
A previously healthy woman in her 30s presented with high-grade fever, photophobia and fluctuating consciousness, and was diagnosed with herpes simplex virus type 1\ encephalitis. Her condition deteriorated, requiring intensive care support for type 1 respiratory failure. During her intensive care unit stay, she was found to have significant left ventricular systolic dysfunction with basal-mid akinesia and apical sparing on echocardiography. Cardiac MRI demonstrated features consistent with stress-induced (Takotsubo) cardiomyopathy. She made a complete neurological and cardiac recovery with supportive care, antiviral therapy and temporary heart-failure therapy. This case highlights the importance of considering cardiac involvement in severe encephalitis and the multidisciplinary management required for rare neuro-cardiac interactions.
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Mathew et al. (2026) studied this question. Severe HSV-1 encephalitis can cause atypical Takotsubo cardiomyopathy with left ventricular systolic dysfunction, reversible with supportive and antiviral therapies.
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