What does this research mean for the field?

Status epilepticus can trigger severe, reversible biventricular Takotsubo syndrome leading to cardiogenic shock and multisystem critical illness. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 1, 2026JACC Case ReportsOpen Access

Severe Biventricular Takotsubo Syndrome Triggered by Status Epilepticus With Pulmonary Embolism and Critical Illness Myopathy

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Why the study?

Research describes clear associations between Takotsubo syndrome and seizures, although the true prevalence remains unclear.

Structured PICO

Population

81-year-old woman presenting with generalized tonic-clonic seizure and nonconvulsive status epilepticus

This case highlights that severe biventricular Takotsubo syndrome can be triggered by status epilepticus, emphasizing the need for early cardiac evaluation in such patients.

Implication

Seizure may trigger reversible severe biventricular Takotsubo shock; leaves open the neurologic precipitants' role pending systematic study.

Abstract

BACKGROUND: Takotsubo syndrome is a reversible stress-induced cardiomyopathy that frequently mimics acute coronary syndrome and is precipitated by intense emotional, neurologic, or physiologic stress. CASE SUMMARY: An 81-year-old woman presented with generalized tonic-clonic seizure and subsequently developed nonconvulsive status epilepticus, cardiogenic shock, and severe biventricular systolic dysfunction with a left ventricular ejection fraction of <20%, later recovering to 55% to 60%. Her hospital course was complicated by subsegmental pulmonary embolism, hypoxic respiratory failure, metabolic encephalopathy, and prolonged intensive care unit stay requiring inpatient rehabilitation for critical illness myopathy. DISCUSSION: Research describes clear associations between Takotsubo syndrome and seizures, although the true prevalence is unclear. This case illustrates Takotsubo as a consequence of neurologic stress, underscoring the importance of early cardiac evaluation. TAKE-HOME MESSAGES: Takotsubo syndrome should be considered in patients with status epilepticus who develop hemodynamic deterioration. These patients need serial reassessment during recovery because severe neurologic illness may evolve into a prolonged multisystem critical illness.