Key result
Treatment with inotropes, vasopressors, and supportive care led to improved cardiac function in 1 postmenopausal woman who developed transient left ventricular apical ballooning.
Case Report (n=1)
This case report highlights the occurrence and supportive management of Takotsubo cardiomyopathy presenting with hemodynamic collapse in a critically ill patient with multiple severe comorbidities.
Case report of TLVAB may aid recognition in the critically ill; leaves open questions on prognosis and management differences.
Transient left ventricular apical ballooning (TLVAB), or Takotsubo cardiomyopathy, is a poorly understood phenomenon that is thought to be related to a surge of catecholamines under stress conditions that causes microvascular dysfunction and a unique pattern of myocardial stunning. TLVAB occurs in two distinct patient populations: (i) community presentation similar to acute coronary syndrome and (ii) the critically ill. Understanding the differences in presentation, prognosis and management between these two groups may improve the outcome. We present a case of TLVAB developing in a Caucasian postmenopausal female who developed TLVAB suddenly on a background of chronic liver disease, malignancy, and recent ischemic stroke. The patient presented with hemodynamic collapse and was treated with inotropes, vasopressors, and supportive care until cardiac function improved. Additionally, we review the current literature describing the risk factors, pathophysiology, and treatment of TLVAB.
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Covell et al. (2012) conducted a case report in Transient left ventricular apical ballooning (Takotsubo cardiomyopathy) (n=1). Inotropes, vasopressors, and supportive care was evaluated. Treatment with inotropes, vasopressors, and supportive care led to improved cardiac function in 1 postmenopausal woman who developed transient left ventricular apical ballooning.
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