Key result
Multidisciplinary management using IABP, distal transradial neurointervention, and structured pharmacotherapy successfully treated a 55-year-old woman with subarachnoid hemorrhage complicated by severe Takotsubo cardiomyopathy, leading to full neurological and cardiac recovery.
Why the study?
Takotsubo cardiomyopathy complicating subarachnoid hemorrhage presents unique management challenges due to the risk of cardiogenic shock and cerebral ischemia.
Case Report (n=1)
No
This case demonstrates the feasibility of managing subarachnoid hemorrhage complicated by Takotsubo cardiomyopathy and cardiogenic shock using IABP, distal transradial aneurysm coiling, and tailored pharmacotherapy.
May inform SAH-TCM management strategies; hypothesis-generating and leaves open prospective validation before practice change.
Takotsubo cardiomyopathy (TCM) complicating subarachnoid hemorrhage (SAH) presents unique management challenges due to the risk of cardiogenic shock and cerebral ischemia. We report the case of a 55-year-old woman with SAH and severe TCM treated successfully through multidisciplinary care involving intra-aortic balloon pumping (IABP), endovascular aneurysm coiling via distal transradial access (dTRA), and a structured pharmacologic strategy, following hemodynamic stabilization, that included angiotensin receptor-neprilysin inhibitors (ARNIs), beta-blockers (BBs), mineralocorticoid receptor antagonists (MRAs), clazosentan, and perampanel. This case illustrates the feasibility of managing complex neurocardiac comorbidity using integrative, anticipatory strategies in a high care unit (HCU) managed directly by neurosurgeons, outside a formal intensive care unit (ICU).
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Okuma et al. (2025) conducted a case report in Subarachnoid hemorrhage complicated by Takotsubo cardiomyopathy (n=1). Distal transradial access (dTRA) coiling and integrated pharmacotherapy under IABP support was evaluated on Clinical recovery and aneurysm occlusion. Multidisciplinary management using IABP, distal transradial neurointervention, and structured pharmacotherapy successfully treated a 55-year-old woman with subarachnoid hemorrhage complicated by severe Takotsubo cardiomyopathy, leading to full neurological and cardiac recovery.
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