Key result
Persistent complete heart block in takotsubo cardiomyopathy requires permanent pacing after 18 days without reversion.
Why the study?
High-degree AV block occurring together with takotsubo cardiomyopathy is a rare and uncommon presentation.
Case Report (n=1)
This case highlights a rare presentation of takotsubo cardiomyopathy complicated by persistent complete heart block requiring permanent pacing.
Persistent complete heart block in takotsubo cardiomyopathy may require permanent pacing; this case leaves open predictors of reversibility and optimal implantation timing.
Takotsubo cardiomyopathy is a type of non-ischemic cardiomyopathy in which there is sudden temporary left ventricular dysfunction. High-degree AV block and takotsubo cardiomyopathy have been reported together rarely in medical literature. Here we discuss a case of takotsubo cardiomyopathy presenting with complete heart block. A 72-year-old female presented with retrosternal chest pain. Electrocardiogram showed complete heart block without any significant ST-T changes. Echocardiogram revealed regional wall motion abnormality not consistent with coronary artery disease and was suggestive of apical ballooning. Coronary angiogram showed no significant coronary artery lesion. LV angiogram showed apical ballooning and LV systolic dysfunction. Patient underwent temporary pacemaker implantation. Since the complete heart block did not revert even after 18 days, she underwent a permanent pacemaker implantation.
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Shanmugasundaram et al. (2012) conducted a case report in Takotsubo cardiomyopathy with complete heart block (n=1). Takotsubo cardiomyopathy with complete heart block was evaluated. A 72-year-old female with takotsubo cardiomyopathy and complete heart block required permanent pacemaker implantation after the block failed to revert after 18 days.
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