Key result
A 69-year-old female with amyotrophic lateral sclerosis developed Takotsubo cardiomyopathy triggered by the emotional and physical stress of a mechanical fall and her terminal diagnosis.
Why the study?
The association between amyotrophic lateral sclerosis and Takotsubo cardiomyopathy has not been well established.
Case Report (n=1)
This case highlights a rare presentation of Takotsubo cardiomyopathy potentially induced by the combined physiological stress of amyotrophic lateral sclerosis and a mechanical fall.
Hypothesis-generating for Takotsubo in ALS; does not support practice change.
Named after the Japanese octopus trap, Takotsubo cardiomyopathy is an acute myocardial condition characterized by a reversible ventricular dysfunction with ballooning of the left ventricle (LV) during systole. A catecholamine surge is likely the primary mechanism responsible for myocardial damage in this condition. The association between amyotrophic lateral sclerosis (ALS) and Takotsubo cardiomyopathy has not been well established. We present a unique case of Takotsubo cardiomyopathy diagnosed in a patient with ALS who presented after a fall with shortness of breath, generalized weakness, and hypotension. She was found to have troponinemia, elevated brain natriuretic peptide, and Osborn waves without ST-segment changes noted on electrocardiography (EKG). The diagnosis of Takotsubo cardiomyopathy was confirmed via transthoracic echocardiography (TTE), which revealed reduced left ventricular ejection fraction, apical ballooning of the LV, akinesis of the ventricular apex, and hyperkinesis of the base of the heart. Coronary angiography revealed no coronary artery disease. She was managed medically and was hemodynamically stable at the time of discharge.
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Munoz et al. (2023) conducted a case report in Takotsubo Cardiomyopathy (n=1). Emotional and physical stress (ALS and mechanical fall) was evaluated on Diagnosis of Takotsubo cardiomyopathy. A 69-year-old female with amyotrophic lateral sclerosis developed Takotsubo cardiomyopathy triggered by the emotional and physical stress of a mechanical fall and her terminal diagnosis.
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