Key result
Four patients hospitalized with COVID-19 developed Tako-Tsubo syndrome with typical apical ballooning and transient left ventricular systolic dysfunction, all fully recovering before discharge.
Why the study?
Growing evidence indicates COVID-19 is associated with increased Tako-Tsubo syndrome incidence, but its presentation and pathophysiology in this setting remain unclear.
Case Report (n=4)
No
COVID-19 may act as a trigger for Tako-Tsubo syndrome, characterized by typical transient left ventricular dysfunction that fully recovers before discharge.
Growing evidence shows that COVID-19 is associated with an increase in Tako-Tsubo syndrome (TTS) incidence. We collected data from patients hospitalized in our multidisciplinary COVID-19 department who had a diagnosis of TTS during the second and third waves of the pandemic in Italy. We reported four cases of TTS associated with COVID-19. Except for COVID-19, no patient had any classical TTS triggers. The mean age was 72 years (67-81) and all patients had COVID-19-related interstitial pneumonia confirmed by computed tomography. Typical apical ballooning and transitory reduction in left ventricle (LV) systolic function with a complete recovery before discharge were observed in all patients. The mean LV ejection fraction at TTS onset was 42% (40-48%). The electrocardiogram showed ST-segment elevation in two cases, while an evolution with negative T waves and corrected QT prolongation was observed in all patients. Three patients underwent coronary angiography. Two patients had Alzheimer's disease. The time interval from hospital admission to TTS onset was 4 (2-6) days, and the time interval from COVID-19 symptom onset to TTS diagnosis was 10 (8-12) days. COVID-19 may be a trigger for TTS, though TTS pathophysiology in COVID-19 patients remains unclear, likely due to its multifactorial nature.
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Alonzo et al. (2023) conducted a case report in COVID-19 and Tako-Tsubo syndrome (n=4). COVID-19 was evaluated on Development and clinical course of Tako-Tsubo syndrome. Four patients hospitalized with COVID-19 developed Tako-Tsubo syndrome with typical apical ballooning and transient left ventricular systolic dysfunction, all fully recovering before discharge.
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