Key result
A 42-year-old female experienced a multiple sclerosis relapse that presented as Takotsubo syndrome, highlighting a rare brain-heart connection likely mediated by excessive sympathetic stimulation.
Why the study?
Only a few cases of MS-induced Takotsubo syndrome have been previously described, and whether TTS can be considered an uncommon extra-neurological manifestation of MS remains debated.
Case Report (n=1)
No
This case highlights Takotsubo syndrome as a potential uncommon extra-neurological manifestation of a multiple sclerosis relapse.
May prompt neuro evaluation in atypical Takotsubo; hypothesis-generating for brain-heart links, should not yet change practice.
We hereby report a puzzling case of multiple sclerosis (MS) relapse presenting as Takotsubo syndrome (TTS). Female, 42-years old, who presented herself to the Emergency Room of University Hospital "ASST Spedali Civili" of Brescia, Italy, for a severe headache and a non-ST-segment elevation acute coronary syndrome. Coronary angiogram showed no signs of coronary atherosclerosis. Upon further neurological evaluation, a diagnosis of MS relapse, related to TTS, was made, and treatment was started accordingly. The patient was discharged after 12 days after the admission, free of symptoms, and without signs of neurological and cardiological active disease. A hallmark of TTS is its association with a preceding stressful event. It may also be connected to a wide variety of diseases, including neurological ones, such as stroke, intracranial bleeding, head trauma, migraine, and seizures. However, up to our knowledge, only few cases of MS-induced TTS were previously described. Whether it is plausible to consider TTS as an uncommon extra-neurological manifestation of MS is still debated, however all the evidence points in that direction, considering the central role of catecholamines in TTS pathogenesis. With this case report the authors hope to encourage research on this field and on the intricate topic of brain-heart connections.
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Dell’Aquila et al. (2020) conducted a case report in Multiple sclerosis relapse presenting as Takotsubo Syndrome (n=1). Multiple sclerosis relapse was evaluated on Clinical presentation and diagnosis. A 42-year-old female experienced a multiple sclerosis relapse that presented as Takotsubo syndrome, highlighting a rare brain-heart connection likely mediated by excessive sympathetic stimulation.
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