A Case of The Development of Takotsubo Syndrome After Electropulse Therapy

The article describes a clinical observation of takotsubo syndrome with the development of cardiogenic shock in a 77-year-old patient with persistent atrial fibrillation after planned electrical impulse therapy to restore sinus rhythm. The diagnosis of ST was confirmed based on laboratory and instrumental data: changes in the electrocardiogram (ST segment elevation in leads V3-4 by 2-3 mm), increased troponin levels (456.8 ng/l), identified left ventricular contractility disorders according to echocardiography (akinesis of all apical segments, anterior, anterior and inferior septal segments at the median level, hypokinesis of the remaining segments at the median level) followed by complete restoration of left ventricular contractility over time, coronary angiography results (no significant stenosis/thrombosis detected) and magnetic resonance imaging data of the heart with gadolinium (no signs of myocarditis, cicatricial changes in the myocardium). The presented clinical case once again emphasizes the importance of awareness of specialists about the possible risk of developing takotsubo syndrome after electrical impulse therapy, as this will allow timely diagnosis and initiation of appropriate treatment. Patients with such risk factors for the development of takotsubo syndrome as a history of mental or neurological diseases, bronchial asthma, chronic obstructive pulmonary disease, diffuse nodular goiter, hypo-/hyperthyroidism, after cardioversion, apparently require more careful and long-term monitoring. Such tactics will probably allow timely diagnosis of this complication to prevent serious consequences, but further study of this issue is required.