Key result
Empirical colchicine treatment in a 64-year-old woman with Takotsubo cardiomyopathy complicated by acute pericarditis resulted in normal ejection fraction and resolution of pericarditis at 4 weeks.
Why the study?
Does colchicine improve acute pericarditis in a patient with Takotsubo cardiomyopathy?
Case Report (n=1)
Does colchicine improve acute pericarditis in a patient with Takotsubo cardiomyopathy?
Highlights acute pericarditis as a potential complication or trigger of Takotsubo cardiomyopathy that can be successfully managed with colchicine.
May support colchicine for pericarditis in Takotsubo; hypothesis-generating and requires prospective trials before practice change.
Case. A 64-year-old Caucasian woman was brought to the emergency department with severe dysphagia and left chest pain for last 4 days. Initial evaluation revealed elevated ST segment in precordial leads on EKG with elevated cardiac enzymes. Limited echocardiogram showed infra-apical wall hypokinesia. Cardiac angiography was done subsequently which showed nonflow limiting mild coronary artery disease. Takotsubo cardiomyopathy was diagnosed and she was treated medically. On the third day of admission, a repeat ECG showed diffuse convex ST-segment elevations in precordial leads, compatible with acute pericarditis pattern of EKG. Decision was made to start colchicine empirically for possible pericarditis. Follow-up EKG in 2 days showed decreased ST-segment elevations in precordial leads. The patient was discharged with colchicine and a follow-up echocardiogram in 4 weeks demonstrated a normal ejection fraction with no evidence of pericarditis. Conclusion. Acute pericarditis can be associated either as a consequence of or as a triggering factor for Takotsubo cardiomyopathy. It is vital for physicians to be aware of pericarditis as a potential complication of Takotsubo cardiomyopathy.
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Kim et al. (2013) conducted a case report in Takotsubo cardiomyopathy and acute pericarditis (n=1). Colchicine was evaluated on Resolution of pericarditis and normalization of ejection fraction. Empirical colchicine treatment in a 64-year-old woman with Takotsubo cardiomyopathy complicated by acute pericarditis resulted in normal ejection fraction and resolution of pericarditis at 4 weeks.
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