Key result
Percutaneous PFO closure was successfully performed in a 16-year-old girl with reverse takotsubo cardiomyopathy triggered by a PFO-related cryptogenic stroke, with no recurrent events at 6 months.
Why the study?
Neurological events have been suggested as typical triggers of reverse takotsubo cardiomyopathy, especially in young individuals, but clinical presentations remain rare.
Case Report (n=1)
No
Reverse takotsubo cardiomyopathy can be triggered by PFO-related cryptogenic stroke, emphasizing the need for prompt diagnosis and multidisciplinary brain-heart team management.
rTTC should be considered in adolescents with embolic stroke and acute HF; supports neurological triggers but remains hypothesis-generating.
BACKGROUND: Reverse takotsubo cardiomyopathy (rTTC) is recognized as an atypical type of TTC. It has been suggested that neurological events are typical trigger of rTTC, especially in young individuals. CASE SUMMARY: In this case report, we describe a 16-year-girl who presented with neurological deficits due to embolic stroke and acute heart failure. Transthoracic echocardiography on admission revealed a severely reduced left ventricular (LV) function with akinesis of basal to mid LV, but normal contraction in apex. Coronary computed tomography angiography confirmed unobstructed coronary arteries. Two weeks later, her LV wall motion and ejection fraction were completely normalized. Transthoracic echocardiography and transoesophageal echocardiography demonstrated no evidence of intracardiac thrombus but showed a patent foramen ovale (PFO) with large shunt. After thorough work-up and brain-heart team discussion, we concluded that the patient developed rTTC due to cryptogenic stroke related with her PFO. She underwent percutaneous PFO closure for secondary prevention with good clinical course. DISCUSSION: Reverse TTC is a rare condition. It should be considered in stroke patients with acute heart failure. Quick diagnosis and management with brain-heart team is crucial for better prognosis.
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Takafuji et al. (2020) conducted a case report in Reverse takotsubo cardiomyopathy and PFO-related cryptogenic stroke (n=1). Percutaneous PFO closure was evaluated on Recurrent adverse events. Percutaneous PFO closure was successfully performed in a 16-year-old girl with reverse takotsubo cardiomyopathy triggered by a PFO-related cryptogenic stroke, with no recurrent events at 6 months.
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