Key result
PPM and medical therapy linked to recovery in Takotsubo with complete heart block and LVOTO.
Why the study?
Takotsubo syndrome presents with a wide spectrum of clinical manifestations, and the coexistence of complete heart block and left ventricular outflow tract obstruction-related mitral regurgitation is rare and poses significant therapeutic challenges.
Case Report (n=1)
This case highlights the successful management of a rare presentation of Takotsubo syndrome complicated by complete heart block and LVOTO-related dynamic mitral regurgitation using permanent pacing and medical therapy.
Vigilance for atrioventricular block is warranted in Takotsubo syndrome; this case leaves open optimal pacing and beta-blocker strategies.
BACKGROUND: Takotsubo syndrome presents with a wide spectrum of clinical manifestations. CASE SUMMARY: A 46-year-old woman presented with chest pain mimicking acute coronary syndrome. Coronary angiography excluded obstructive coronary disease, and imaging findings confirmed Takotsubo syndrome complicated by complete atrioventricular block and left ventricular outflow tract obstruction with mitral regurgitation. The patient underwent permanent pacemaker implantation and was started on beta-blocker therapy with angiotensin-converting enzyme inhibitors. Subsequent clinical and echocardiographic recovery was observed. DISCUSSION: The coexistence of complete heart block and left ventricular outflow tract obstruction-related mitral regurgitation in Takotsubo syndrome is rare and poses significant therapeutic challenges. TAKE-HOME MESSAGES: This case highlights the complexity of management and provides insights into the underlying pathophysiological mechanisms of theses complications.
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Bechir et al. (2026) conducted a case report in Takotsubo syndrome complicated by complete atrioventricular block and left ventricular outflow tract obstruction with mitral regurgitation (n=1). Permanent pacemaker implantation, beta-blockers, and angiotensin-converting enzyme inhibitors was evaluated on Clinical and echocardiographic recovery. Permanent pacemaker implantation and medical therapy led to clinical and echocardiographic recovery in a 46-year-old woman with Takotsubo syndrome complicated by complete heart block and LVOTO.
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