Key result
Case report reveals four recurrent Takotsubo episodes within 10 months with distinct triggers and wall-motion patterns.
Why the study?
The recurrence of Takotsubo syndrome has been investigated, but cases of multiple recurrences are scarcely reported.
Case Report (n=1)
This case highlights that Takotsubo syndrome can recur multiple times within a short period, with varying triggers and distinct patterns of myocardial dysfunction in the same patient.
Recurrent Takotsubo with variable triggers and LV patterns warrants clinical vigilance; leaves open mechanisms and prevention strategies.
BACKGROUND: Takotsubo syndrome (TTS) is characterized by transient left ventricular (LV) dysfunction, often preceded by emotional or physical trigger. The recurrence of TTS has been investigated, however, cases of multiple recurrences are scarcely reported. CASE SUMMARY: A 79-year-old woman was admitted to the hospital with the complaint of dyspnoea following emotional stress. Electrocardiogram showed terminal T-wave inversion with QT interval prolongation in anterior leads. Transthoracic echocardiogram revealed severe hypokinesis of mid- and apical-anterior segments. She was diagnosed with focal TTS. After 3 months, she complained of orthopnoea subsequent to upper-respiratory infection. Coronary angiography (CAG) depicted normal coronary arteries. She had recurrence of TTS with bi-ventricular dysfunction, and complicated cardiac collapse requiring intra-aortic balloon pumping. One month after the second episode, she had dyspnoea after herpes zoster infection. She was diagnosed with recurrence of focal TTS. After 4 months, she complained of central chest pain without evident trigger factors. CAG showed no coronary artery stenosis, and left ventriculography revealed mid-inferior and apical segment akinesis. She was diagnosed with the 4th occurrence of TTS. DISCUSSION: We describe the case of an elderly female experiencing quadruple episodes of TTS with various triggers, LV dysfunctions and severities in a short period of 10 months. Although multiple recurrences of TTS is rare, it can occur with variable trigger factors and patterns of myocardial dysfunction. An analysis of multiple recurrences could aid in clarifying the pathophysiology of TTS.
No takes yet. Share an insight, caveat, or question.
Hiruma et al. (2021) conducted a case report in Takotsubo syndrome (n=1). Various triggers (emotional and physical stress) was evaluated on Recurrence of Takotsubo syndrome and patterns of myocardial dysfunction. An elderly woman experienced four distinct episodes of Takotsubo syndrome within 10 months, each presenting with different triggers and varying patterns of left ventricular dysfunction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: