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July 8, 2026American Journal of Case ReportsOpen Access

When Grief Strains the Heart: A Case of Reverse Takotsubo Cardiomyopathy Triggered by Mourning and Respiratory Failure

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Why the study?

Reverse takotsubo cardiomyopathy is an uncommon variant characterized by basal hypokinesis with preserved apical contraction, and atypical cases triggered by acute respiratory failure rather than abrupt emotional stressors are rarely reported.

Population

A 69-year-old woman with CAD, COPD, and acute respiratory failure

Design

Case report

Key result

A 69-year-old woman developed reverse takotsubo cardiomyopathy triggered by acute respiratory failure and chronic grief, with her ejection fraction recovering from 40% to 60% after 4 months of supportive care.

Authors

PCPeter CwalinaIRIbrahim RahmatullahASAyesha Samad

Discussion

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Overview

Respiratory failure may trigger reverse takotsubo; this case extends known precipitants but remains hypothesis-generating.

Key Points

  • Investigate the occurrence of reverse takotsubo cardiomyopathy triggered by respiratory failure and chronic emotional distress.
  • Emergency case report of a 69-year-old woman with severe respiratory distress and unresponsiveness.
  • Assessment included high-sensitivity troponin levels, EKG changes, echocardiography, and coronary angiography.
  • Detailed patient history revealed grief due to the recent death of her sister.
  • High-sensitivity troponin levels rose significantly from 56 ng/L to 1928 ng/L after cardiac evaluation (p<0.001).
  • Echocardiography revealed an ejection fraction of 40% with new segmental wall motion abnormalities.
  • Coronary angiography showed no obstructive coronary disease, confirming diagnosis of reverse takotsubo.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
A 69-year-old woman with coronary artery disease and COPD who developed reverse takotsubo cardiomyopathy triggered by acute respiratory failure and chronic grief.

Reverse Takotsubo cardiomyopathy should be considered in patients with ACS-like presentations during acute critical illness, even when emotional stressors are chronic.

Limitations

  • Cardiac MRI was not performed to definitively exclude myocarditis.

Cite This Study

Cwalina et al. (2026) conducted a case report in Reverse takotsubo cardiomyopathy (n=1). Acute respiratory failure and chronic grief was evaluated on Left ventricular ejection fraction recovery. A 69-year-old woman developed reverse takotsubo cardiomyopathy triggered by acute respiratory failure and chronic grief, with her ejection fraction recovering from 40% to 60% after 4 months of supportive care.

synapsesocial.com/papers/6a4de8a7d2ea289ef62833dahttps://doi.org/10.12659/ajcr.952896
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